In an exclusive interview, Alexion R&D head John Orloff takes In Vivo on a tour around the company’s rejuvenated pipeline and explains how the business is innovating to pre-empt the Soliris-shaped hole in its balance sheet.

Europe’s patchwork of reimbursement agencies make it a daunting place for a small US biotech to do business. Traditionally large pharma partners or CMSOs have provided an experienced hand to hold, but as a new wave of gene therapies and orphan drugs get the EMA green light, smaller drug developers are applying innovation to commercialization and choosing to go solo.

Nine months after the US approval, the EU has followed suit and given a conditional approval for Sanofi and Regeneron’s IO Libtayo for a, so far, untreatable skin cancer.