过去几年，罕见病药物断供事件偶有发生，但"超罕"家庭面临的困境更为残酷——无药可用甚至成为常 态。 超罕见病(俗称"超罕")，是罕见病中患病率极低、确诊人数极少的细分群体。据国家卫健委第二届罕见 病诊疗与保障专家委员会委员谢俊明介绍，如果一种疾病的发病人数在1400人以内，即发病率低于百万 分之一，那么这种疾病就是"罕见病中的罕见病"。戈谢病、庞贝病、法布雷病等均在此列，国内确诊患 者仅数百人。 近年来，国内罕见病领域的用药难问题取得多项突破。截至去年底，90余种罕见病治疗药品已纳入国家 医保药品目录。据蔻德罕见病中心统计，共覆盖《罕见病目录》里超过50种罕见病。 但是，"超罕"家庭的困境却鲜有人知。李明(化名)是一位8岁EA患儿的母亲。几年前，她的女儿出现反 复症状，时而严重，时而轻微。辗转多家医院问诊治疗一直没找到缓解的办法，在发病三年后，最终被 确诊为EA。 公开资料显示，这是一类以发作性小脑功能障碍为特征的神经系统遗传病，核心表现为间歇性共济失调 发作，发作期间患者神经功能通常正常或仅伴轻微症状。由于过于罕见，EA缺乏系统性流行病学调 查，暂无公开的患者数量或发病率数据，且间歇性特征使其更难识别统计， ...

Summary of Amicus Therapeutics Conference Call Company Overview - **Company**: Amicus Therapeutics (NasdaqGM:FOLD) - **Focus**: Rare disease therapeutics with a unique position in the biotech sector, targeting first or best-in-class medicines [3][4] Key Products and Financials - **Galafold**: - Approved for Fabry disease since 2016 - Expected growth of 10%-15% in 2025, with over $500 million in sales [3][4] - Currently holds a 65% market share among treated amenable patients, with potential to increase to 85%-90% in established markets [5][6] - **Pombiliti (Opfolda)**: - Launched in 2023, showing 50%-65% growth, projected to exceed $100 million in sales [4][5] - Strong patient demand in the U.S. and expansion into new countries [8][9] - **DMX-200**: - Targeting Focal Segmental Glomerulosclerosis (FSGS), a rare kidney disease with no approved treatments [4][29] - Positioned as a potential blockbuster with a unique mechanism of action [29] - **Financial Position**: - Projected revenue of over $600 million in 2025, aiming for $1 billion by 2028 [4][5] - Currently holds over $260 million in cash, with positive cash generation of over $30 million in Q3 [4][5] Market Dynamics and Growth Drivers - **Galafold**: - Growth driven by increased patient diagnoses and treatment initiation [5][6] - Newborn screening initiatives and family cascade testing are significant tailwinds [6][12] - The total diagnosed Fabry patient population has grown from 10,000 to nearly 20,000, with potential for over 100,000 undiagnosed patients [14] - **Pombiliti**: - Strong momentum in new patient additions, particularly from patients previously on Nexviazyme [8][11] - Geographic expansion with eight new countries added this year, aiming for ten total [9][18] Competitive Landscape and Pricing Strategy - **Pricing Strategy**: - Amicus maintains a pricing philosophy focused on access, pricing below competitors and committing to not raise prices above the Consumer Price Index (CPI) [19][20] - No significant pricing erosion observed in the U.S. or ex-U.S. markets [19][20] - **Market Share**: - Achieved over 40% market share in the U.K. for Pombiliti, with expectations for similar performance in other markets [19] Regulatory and Development Updates - **Intellectual Property (IP)**: - Galafold has patent protection extending into the 2040s, with ongoing litigation against generic filers [23][24] - Anticipated resolution of IP trials in the second half of next year [24] - **DMX-200 Development**: - Enrollment for the Action 3 study is over 90% complete, with top-line data expected in two years [37][38] - Potential for accelerated approval discussions based on one-year data [39] Upcoming Catalysts - Continued patient addition and revenue growth for Galafold and Pombiliti [40] - Updates on Galafold IP resolution and Pombiliti's pediatric label expansion expected in mid-2026 [41] - Completion of DMX-200 enrollment and potential updates on FDA discussions in the first half of next year [41]

Summary of Savara FY Conference Call - November 10, 2025 Company Overview - **Company**: Savara (NasdaqGS:SVRA) - **Focus**: Single asset rare disease company - **Product**: Mulibrev (molgramostim inhalation solution) - **Indication**: Autoimmune pulmonary alveolar proteinosis (aPAP), a rare lung disease - **Regulatory Status**: Resubmission of Biologics License Application (BLA) projected for December 2025, with Marketing Authorization Applications (MAAs) planned for Europe and the U.K. in Q1 2026 [4][6][37] Key Points and Arguments Regulatory Developments - **BLA Submission**: Initial rolling submission began in December 2024, finalized in March 2025, but received a refusal to file (RTF) from the FDA in May 2025 due to manufacturing data issues [7][8] - **Manufacturing Strategy**: Transitioning to Fujifilm in the U.K. as the primary drug substance manufacturer following the RTF, supported by a Type A meeting with the FDA [8][9] - **IMPALA-2 Trial**: First and only application for aPAP, with breakthrough designation highlighting significant unmet need. Primary endpoint (DLCO) met statistical significance at 24 weeks, with durability observed at 48 weeks [12][14][16] Clinical Trial Insights - **Trial Design**: Global study with 164 patients across 43 centers in 16 countries. Key secondary endpoints included SGRQ and exercise capacity via treadmill test, both showing significant results [15][16][18] - **Patient Retention**: 100% of patients completed the trial and transitioned to open-label extension, indicating strong engagement and treatment interest [18] Market Opportunity - **Current Management of aPAP**: Existing treatment involves whole lung lavage, a mechanical procedure that does not address the underlying disease. Mulibrev targets the root cause by addressing GM-CSF signaling [21][22] - **Market Size Update**: Recent analysis identified approximately 5,500 patients with autoimmune PAP in the U.S., a 50% increase from previous estimates of 3,600 patients [23][25] - **Physician Distribution**: Approximately 1,100 centers manage these patients, with a customer-facing group of 25-30 expected to effectively address the patient population [26][27] Commercial Strategy - **U.S. Strategy**: Plans to go it alone in the U.S. market, with a focus on building disease awareness and diagnostic testing capabilities [28][29] - **International Strategy**: Similar approach in Europe and the U.K., while Asia Pacific presents challenges due to policy issues [29][30] - **Financing**: Recent two-step financing strategy was opportunistic, aimed at ensuring sufficient runway for operations and market entry [31][33] Future Outlook - **Regulatory Timeline**: Anticipated PDUFA date around August 2026, assuming priority review is granted [40] - **Market Readiness**: Company is well-capitalized and focused on execution to meet market expectations [36][37] Additional Important Insights - **Antibody Testing Program**: Ongoing no-cost antibody testing program is being utilized, with potential for future updates on testing numbers and market expansion [35][36] - **Unmet Need**: The significant unmet need in the aPAP market underscores the potential impact of Mulibrev as a treatment option [36]

Financial Data and Key Metrics Changes - The company reported third quarter revenue of $133 million, representing a nearly 50% year-over-year increase [4][16] - Total net product revenue increased by 47% compared to the prior year, reflecting growth across all commercial medicines [16] - The company achieved positive net income for the first time, generating approximately $3 million in net income [5][17] Business Line Data and Key Metrics Changes - LIVMARLI net product sales totaled $92 million for the quarter, with $64 million from the US and $28 million from international markets [7][9] - The bioacquired medicines, CHOLBAM and CHENODAL, generated $41 million in net product sales this quarter [9] - The company expects to land in the upper end of its prior full year 2025 guidance range, with projected revenues of $500-$510 million [9] Market Data and Key Metrics Changes - Demand for LIVMARLI in the US remains healthy, particularly in Alagille syndrome and PFIC, supported by expanded diagnosis and increased genetic screening [8] - Internationally, LIVMARLI demand continues to grow, with significant contributions from new geographies and expanding reimbursement [9] - The company noted variability in international partner and distributor ordering patterns affecting revenue projections [9] Company Strategy and Development Direction - The company aims to advance its clinical pipeline with three potentially pivotal readouts expected over the next 18 months [5] - The focus remains on building a high-growth, cash flow positive rare disease company with a broad pipeline and global footprint [6] - The company is actively looking for underappreciated programs to add to its pipeline, maintaining a high bar for new product acquisitions [50] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the continued growth potential across the portfolio, with peak revenue potential for LIVMARLI, Volixibat, and MRM-3379 each exceeding $1 billion [10] - The company highlighted the importance of sustained engagement with the medical community to drive incremental gains in genetic testing and diagnosis [8] - Management emphasized the strength and scalability of the business model, viewing quarterly GAAP profitability as a milestone rather than a consistent expectation [17] Other Important Information - The company completed enrollment in the phase 2b VISTAS study in primary sclerosing cholangitis (PSC) and expects to announce top-line data in the second quarter of 2026 [11] - The VANTAGE study continues to progress well, with interim data showing statistically significant improvements in pruritus and other key measures [12] - The company initiated a phase 2 study of MRM-3379 for Fragile X syndrome, with promising preclinical data supporting its efficacy [13] Q&A Session Summary Question: Key drivers of LIVMARLI's performance in 2026 and guidance for Q4 revenue - Management expects continued growth from the PFIC launch and noted that international revenue may show variability due to large distributor orders [20][22] Question: Trends in adoption of LIVMARLI's solid tablet formulation and pricing for Volixibat - The solid tablet formulation has seen encouraging uptake, with a substantial proportion of eligible patients switching from the liquid form [25][26] - Pricing for Volixibat is still under analysis, with comparisons to other PPARs in the market [26] Question: Expectations for Paragraph IV filers and confidence in IP portfolio - Management expressed confidence in the overall IP position, particularly regarding method patents for LIVMARLI [30] Question: Insights on Fragile X study endpoints and safety risks in PSC - Management is optimistic about the endpoint strategy for Fragile X and noted no significant safety issues in the PSC study [33][37] Question: Impact of government shutdown on genetic screening programs - No impact has been observed on genetic screening programs or business interactions due to the government shutdown [46] Question: Pace of new PFIC adds and business development strategy - The pace of new PFIC adds remains healthy, with ongoing educational efforts to increase awareness among adult providers [48] - The company continues to seek underappreciated programs for its pipeline, maintaining a high standard for new acquisitions [50] Question: Competitive dynamics in PBC with recent market entrants - Management highlighted the unique positioning of Volixibat in the PBC treatment landscape, emphasizing its potential in both first and second-line settings [52]

Core Viewpoint - Heng Rui Medicine's subsidiary Chengdu Shengdi Pharmaceutical Co., Ltd. has announced that its HRS-5965 capsule is proposed to be included in the priority review list by the National Medical Products Administration (NMPA) [1] Group 1: Product Information - HRS-5965 capsule is a complement factor B inhibitor designed to suppress complement-mediated intravascular and extravascular hemolytic reactions, thereby improving hemoglobin levels [1] - The condition targeted by HRS-5965, Paroxysmal Nocturnal Hemoglobinuria (PNH), is a rare acquired hemolytic disease characterized by the deficiency of CD55 and CD59, leading to complement-mediated intravascular hemolysis [1] Group 2: Market Context - PNH has a low incidence/prevalence rate and has been included in the National "First Batch of Rare Diseases Directory" [1]

Core Viewpoint - Heng Rui Medicine's subsidiary Chengdu Shengdi Pharmaceutical's HRS-5965 capsules have been proposed for inclusion in the priority review list by the National Medical Products Administration [1] Group 1: Product Information - HRS-5965 capsules are a complement factor B inhibitor designed to suppress complement-mediated hemolytic reactions and improve hemoglobin levels [1] - The target indication is Paroxysmal Nocturnal Hemoglobinuria (PNH), a rare acquired hemolytic disease characterized by the lack of CD55 and CD59, leading to complement-mediated intravascular hemolysis [1] Group 2: Market Context - PNH has been included in the national list of rare diseases due to its low incidence/prevalence [1] - Currently, the only drug approved for this indication is Novartis' Iptacopan (Fabhalta®), which is projected to have a global sales revenue of approximately $129 million in 2024 according to EvaluatePharma [1] Group 3: R&D Investment - The cumulative R&D investment for the HRS-5965 project has reached approximately 209.94 million yuan [1]

Core Viewpoint - Heng Rui Medicine's subsidiary Chengdu Shengdi Pharmaceutical Co., Ltd. has announced that its HRS-5965 capsule is proposed to be included in the priority review list by the National Medical Products Administration (NMPA) [1] Group 1: Product Information - HRS-5965 capsule is a complement factor B inhibitor designed to suppress complement-mediated hemolytic reactions, thereby increasing hemoglobin levels [1] - The condition targeted by HRS-5965, Paroxysmal Nocturnal Hemoglobinuria (PNH), is a rare acquired hemolytic disease characterized by the deficiency of CD55 and CD59, leading to complement-mediated intravascular hemolysis [1] Group 2: Market Context - PNH has a low incidence/prevalence rate and has been included in the National "First Batch of Rare Diseases Directory" [1]

Core Insights - WP103 is an innovative drug developed by the company for treating neonatal Hypoxic-Ischemic Encephalopathy (HIE) and has received FDA approval for clinical trials starting in January 2025 [1] - The drug has shown promising results in preclinical studies, demonstrating effectiveness in reducing brain injury risk, accelerating neurological recovery, and reversing behavioral deficits [1] - WP103 has received both Rare Pediatric Disease Designation (RPDD) and Orphan Drug Designation (ODD) from the FDA, indicating its innovative value and potential clinical demand in the neonatal HIE treatment space [2] Company Developments - The company has conducted large animal non-clinical pharmacodynamic trials to support the initiation of critical registration clinical studies for HIE, which are essential for bridging basic research and clinical application [1] - The dual designation of RPDD and ODD provides the company with various policy supports, including market exclusivity, exemption from new drug application fees, and expedited review processes, which will facilitate global clinical development and commercialization of WP103 [2] - The company plans to engage in further discussions with the FDA regarding trial results and must conduct a series of clinical trials in compliance with U.S. drug registration regulations before the drug can be marketed [2]

Financial Data and Key Metrics Changes - In Q3 2025, Agios Pharmaceuticals reported net revenue of $12.9 million, a 44% increase compared to $9 million in Q3 2024, and a 3% increase from $12.5 million in Q2 2025 [8][6][9] - The cost of sales for the quarter was $1.7 million, while R&D expenses rose to $86.8 million, an increase of $14.3 million compared to the previous year [9][10] - SG&A expenses were $41.3 million, up $2.7 million year-over-year, reflecting disciplined investment ahead of potential product launches [9] Business Line Data and Key Metrics Changes - PYRUKYND net revenue was $12.9 million, reflecting strong commercial execution in PK deficiency ahead of potential U.S. approval for thalassemia [8][12] - 262 patients completed prescription enrollment forms, with 149 currently on therapy, marking a 5% increase from the second quarter [12][13] Market Data and Key Metrics Changes - Agios received approval for PYRUKYND in adults with thalassemia in Saudi Arabia, marking its first global regulatory approval for this indication [6][18] - A positive CHMP opinion was received for PYRUKYND in Europe, with a regulatory decision anticipated in early 2026 [18][19] Company Strategy and Development Direction - The company is focused on unlocking long-term shareholder value through multiple high-value catalysts, including the upcoming PDUFA date for PYRUKYND in thalassemia [5][6] - Agios is pursuing a capital-efficient global commercialization strategy through partnerships, retaining full rights to PYRUKYND while minimizing capital investment for U.S. launches [10][13] - The company aims to expand and diversify its pipeline through both internal efforts and external assets [10][28] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the ability to deliver a successful launch for PYRUKYND in thalassemia, emphasizing the critical need for treatment innovation in the community [7][16] - The company anticipates continued revenue growth in 2025, driven by strong execution of its sales force [9][10] Other Important Information - Agios has approximately $1.3 billion in cash and investments, positioning it to invest in potential U.S. launches and advance its rare disease pipeline [6][10] - The company completed enrollment in the Phase 2b trial of tebapivat for lower-risk myelodysplastic syndromes, with top-line data expected early next year [9][24] Q&A Session Summary Question: What type of REMS program is the FDA interested in for thalassemia? - Management indicated that the REMS program will include monitoring and some form of education, but specific details cannot be disclosed at this time [33] Question: What type of business development makes sense for the company at this stage? - The company is looking for transformative therapies for rare diseases and is not tied to any specific timeline for transactions [34] Question: What are the liver monitoring requirements in Saudi Arabia and Europe? - In Saudi Arabia, monitoring is required once a month for the first six months, while the European label is still pending [41] Question: How is the commercial approach changing due to monitoring requirements? - Management does not anticipate REMS to be a barrier to prescribing, as both academic and community practices have experience with such programs [43] Question: What is the strategy for the European thalassemia launch with Avanzanite? - The pricing and reimbursement process in Europe can take 12 to 18 months post-approval, and the company is working closely with Avanzanite to refine its strategy [51]

Financial Data and Key Metrics Changes - Total revenues for Q3 2025 were $120.7 million, a significant increase from $2.7 million in the same period last year, primarily driven by $108.1 million in net product revenue from Atrobi [25][26]. - Total operating expenses increased to $259.3 million from $193.9 million year-over-year, with a notable rise in SG&A expenses by $68.8 million [26][27]. - The company ended Q3 with a strong cash position of $645.9 million, providing a solid cash runway for future operations [27]. Business Line Data and Key Metrics Changes - Atrobi generated $108.1 million in net product sales, with 5,259 unique patient prescriptions delivered to 1,355 unique healthcare providers [11][25]. - The company reported strong growth in the ATTR-CM market, with an increase in prescribing from both returning and new physicians [18][21]. Market Data and Key Metrics Changes - The ATTR-CM market continues to expand, with no signs of slowing down, contributing to a sustained growth runway for Atrobi [21]. - The company is seeing increased diagnosis rates for ATTR-CM, with expectations to reach closer to 250,000 diagnosed patients in the U.S. [39]. Company Strategy and Development Direction - The company aims for a market share of 30+% by volume in the coming years, focusing on the continued success of Atrobi and the upcoming launches of Encalirate and BBP-418 [6][11]. - The company is actively building infrastructure for global commercialization to ensure access to its therapies worldwide [24]. Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the ongoing success of Atrobi and the potential for strong market share growth, supported by positive clinical data from recent trials [6][11]. - The company is optimistic about the upcoming readouts for Infogratinib and the continued expansion of its pipeline [22][24]. Other Important Information - The company has a robust late-stage pipeline, with significant progress in R&D, including two recent positive phase 3 trial results [4][6]. - The company is focused on leveraging real-world evidence to support its market position and drive adoption of its therapies [16][78]. Q&A Session Summary Question: What is the percentage of new patient share for Atrobi? - Management estimates that the naive share is well in the 20s, with double-digit growth in overall prescriptions quarter-on-quarter [30][31]. Question: Can you elaborate on ATTR-CM diagnosis rates? - There has been robust growth in diagnosis rates, with ongoing education and excitement in the medical community about ATTR cardiomyopathy [39]. Question: Thoughts on Pfizer's 28-day free trial program? - Management views it positively as it encourages competition and emphasizes the importance of access for patients [44][46]. Question: How does the ex-US opportunity compare to the US market? - The ex-US opportunity is promising, with Bayer successfully commercializing in Europe, although pricing dynamics differ [50][52]. Question: Will there be a head-to-head study against Tafamidis? - Management believes that real-world evidence will be more impactful than a costly head-to-head study, as they already demonstrate superior efficacy [72][78]. Question: What differentiates Infogratinib in achondroplasia? - Infogratinib is expected to be more efficacious, safer, and more convenient due to its oral administration, addressing unmet needs in the market [83][86].