The new CEO has at least five years and a large M&A war chest to position Sanofi for life after the loss of exclusivity on its cornerstone immunology product.
Belén Garijo takes over as Sanofi CEO this week facing an $18 billion question: How to protect or replace Dupixent sales beyond the 2031 patent expiry. The new CEO’s tools for tackling the challenge include a pipeline that has suffered setbacks, an existing strategy for holding off biosimilar Dupixent copies and an M&A budget that could support buyouts approaching $30 billion.
Sanofi let former CEO Paul Hudson go in February and unveiled Garijo as his replacement, effective April 29. Hudson exited in the wake of the FDA’s rejection of tolebrutinib in multiple sclerosis and mixed or negative clinical data on drug candidates including amlitelimab in asthma, balinatunfib in psoriasis and itepekimab in chronic obstructive pulmonary disease. Sanofi bet billions of dollars on these molecules under Hudson.
Former Sanofi CEO Paul Hudson.
Wikimedia Commons/RachelGross
Regulators approved products such as the hemophilia A drug Altuviiio and the respiratory syncytial virus antibody Beyfortus on Hudson’s watch, adding growth drivers. But the company remains heavily reliant on Dupixent, the autoimmune blockbuster that Sanofi markets with Regeneron. Under Garijo, Sanofi will need to lessen that reliance to prevent problems in the future.
Preparing for life after Dupixent
Dupixent revenues continue to outperform expectations, BMO Capital Markets analysts said in a note to investors after a quarter in which sales jumped 31%. The first-quarter increase followed a year in which Sanofi’s Dupixent sales rose 20% to €15.7 billion ($18.4 billion). It is unclear how long Dupixent will drive growth, though, with off-patent competitors potentially arriving as early as 2031.
Sanofi laid out its plans for defending Dupixent last week, detailing a strategy underpinned by more than 50 patents that extend out to 2045. Regeneron is leveraging the expertise of people who worked on the intellectual property for AbbVie’s Humira, a drug with a famously long lifecycle, to develop the Dupixent strategy, BMO analysts said.
However well the Dupixent patent strategy works, Sanofi’s star drug will wane at some point. If the company’s existing pipeline fails to deliver successes, Garijo could buy her way out of the problem. On an earnings call last week, Sanofi CFO François-Xavier Roger reiterated his belief that the drugmaker can spend up to €15 billion on deals while retaining its credit rating.
Roger added a detail that was missing when he discussed Sanofi’s spending power on the previous earnings call in January. If Sanofi buys a commercialized asset, it could potentially spend up to €10 billion more while retaining its credit rating, the CFO said. Conversely, the pharma will have a lower ceiling if it buys early-phase assets.
These comments suggest Sanofi has the firepower to strike its biggest deal since buying Aventis in 2004, with the limit for buying a commercial asset exceeding the $20.1 billion paid for Genzyme in 2011. The war chest informed the confidence of Leerink Partners analysts, who said in a note to investors that the new CEO has the financial flexibility and the time to acquire assets and reinvigorate the pipeline.
Leerink expects Dupixent to face biosimilar competition for the eczema market in October 2033, giving Garijo seven years to prepare the company for the erosion of its cornerstone product. Interim CEO Olivier Charmeil said on Sanofi’s latest earnings call that Garijo should “take some time to make the right diagnostic” before putting her mark on the company.
Based on conversations with people at Sanofi, Guggenheim Securities analysts said in a note to investors this month that “there is unlikely to be a massive shift in overall strategy” after Garijo takes over. The new CEO will likely present more details of her strategy late this year or early next year, the analysts said.
Garijo’s track record as CEO
Garijo’s time at Merck KGaA offers clues about her potential strategy at Sanofi. The physician took over as CEO at Merck KGaA in 2021, when the COVID-19 pandemic was inflating demand for its life sciences products. What happened next shows potential differences between that position and leading Sanofi.
As the pandemic-driven boom faded, Merck KGaA’s diversified business, which includes an electronics unit, helped soften the blow. Speaking to Semafor in November 2025, Garijo said, “If we had been a pure-play pharma, I don’t even want to think of the pain we would have gone through.”
Garijo concluded that diversification was a strength for Merck KGaA. Sanofi adopted a different view under Hudson, selling a 50% stake in its consumer health unit to narrow its focus to innovative medicines. Garijo is going from a diversified company where the largest of the three entire businesses accounted for 43% of sales last year to a focused drugmaker that relied on a single medicine for 36% of revenue.
Ownership is another difference between Merck KGaA and Sanofi. Descendants of Merck KGaA’s founder own 70% of the business through a holding company. Garijo said the family’s role provides a long-term perspective, meaning that driving sustainable growth takes precedence over immediately improving the share price.
Under Garijo, Merck KGaA shifted from using M&A to add scale to a “string of pearls” approach focused on smaller to mid-sized acquisitions. Merck KGaA’s $3.9 billion SpringWorks Therapeutics takeover was Garijo’s biggest biopharma bet. Garijo was able to resist calls from non-family investors for Merck KGaA to strike more life sciences deals because of the company’s ownership structure, Semafor reported.
Sanofi lacks an equivalent stabilizing force, leaving scope for activist investors to ratchet up the pressure on Garijo if they become dissatisfied with the company’s direction or progress. The pharma’s shares declined when Hudson’s departure and Garijo’s appointment was announced in February. Dupixent’s inexorable rise likely gives Garijo time to win over investors, but, as Hudson discovered at his expense, the situation can change quickly.
