“Now we do expect continued TRx volume growth, but there will be GTM pressure on U.S. performance, and that's a function of both the Medicare Part D design, but also a result of contracting to maintain access for Vynda, both in Medicare and commercial, where we've maintained 90% access for the brand.”

In context

“kly about Vyndaqel in the U.S. and then touch on international, too. In the U.S., yes, we had a very strong quarter. We had 15% year-over-year growth. We maintained momentum and performance versus Q1. And there's a lot that's going on in this market right now. So that performance is a function of improving diagnosis as well as improving favorability dynamics. So we continue to lead in the face of 2 competitors coming into that market, both in terms of total market share, but also importantly, lead in terms of first-line treatment-naive patient share. So we've got good TRx momentum, and that's influenced the growth. Attruby is taking some first-line share, and it's a little too early to tell about the dynamics of AMVUTTRA, and we'll keep a close eye on that for the second half of the year. Now we do expect continued TRx volume growth, but there will be GTM pressure on U.S. performance, and that's a function of both the Medicare Part D design, but also a result of contracting to maintain access for Vynda, both in Medicare and commercial, where we've maintained 90% access for the brand. So we do expect those dynamics to impact our sequential growth in the back half of this year. David M. Denton: Yes. For international, so we have a very strong dynamic. So we have grown 32% for the quarter. But actually, since the beginning of the year, we have grown our patient treated by 50%. So it's clearly the -- what I was describing at the beginning in terms of focus on the key assets where we think we can have an impact. This one is clearly the demonstration of our focus on execution. Moving forward, we think we're going to continue to grow on this product for three reasons. First, the WCS rate in international in most of our key markets is still significantly below what we have in the U.S. and we normally see in this type of disease. Two, the access. Access takes a lot of time in”