As one of the world’s five biggest pharmaceutical companies, France’s Sanofi (SNY) is a $147 billion titan with operations on multiple continents. It generated over $47 billion in sales in 2017 behind top selling drugs like Ambien, Lantus, Lovenox and Allegra, among many others. Like its major competitors, Sanofi offers both prescription and generic drugs to a species that can’t seem to medicate quickly enough. Several species, in fact. The company also makes anti-flea-and-tick chew treats for dogs, and parasite medications for livestock.

Take This, You’ll Feel Better

But human pharmaceuticals, for ailments of varying seriousness, still dominate the industry. Sanofi organizes said business into the following categories: diabetes, MS, oncology, thrombosis/cardiovascular, nephrology, biosurgery, and rare diseases. “Rare diseases” include Gaucher disease and Pompe disease, the former afflicting one person in 50,000 - 100,000. (The primary treatment for Pompe disease, Lumizyme, retails for more than $800 a vial).

Such drugs make lots of money for Sanofi on a per-patient basis, but that’s not where the company’s strengths lie. While major pharmaceutical companies turn a profit on high-margin, dizzyingly expensive drugs. (e.g. Soliris, which fights a rare blood disorder and a vial of which can be yours for a mere $6600), the drugs that have turned Sanofi a $33.5 billion profit in the most recent fiscal year are mostly low-margin, high-volume items that the company sells to tens of millions of end users worldwide. (For more, see: Big Pharma's Big Problem.)

Those end users don’t buy directly from Sanofi, of course. Which gives us an opportunity to use one of the most mellifluous words in finance – “oligopsony." In the United States, Sanofi derives 16% of its net sales through a mere three wholesalers. Should one of them become illiquid, it could end up compromising Sanofi’s entire North American operations in the short term.

Prescribed by the Millions

Every pharmaceutical company has a top seller, the drug equivalent of a Camry or an Adele album. In Sanofi’s case, that top seller is Lantus. It’s a form of insulin used for both types I and II diabetes, and it brought in $4.0 billion in 2019. Lantus sells for about $4 a dose at retail, and is usually administered daily. Via a pen, which is a radical improvement over the hypodermic needles used by diabetics in generations past. (And a far more radical improvement over the premature death accepted by diabetics of even longer ago.) (For related reading, see: Johnson & Johnson's Q4 Profit Boosted By Drugs.)

Is it good news or bad news that Lantus sales in “emerging markets” exceeded those in Europe last year, $1.4 billion to $760 million? It could be good, because it means that people in poor countries can now afford more diabetes medication. Or perhaps it’s bad, because more of those same people are now being diagnosed with diabetes? Either way, such sales are but a fraction of those in the United States, which topped $1.5 billion last year.

As successful as Lantus has been for Sanofi, the pharmaceutical business is a constant race to stay on top of science and intellectual property law simultaneously. Most of the patents on Lantus expired in 2015, and while Sanofi’s generics business will pick up much of the slack, plenty of the profit enjoyed by the production of Lantus will be lost forever to Eli Lilly 7 Co. (LLY) and other enterprising competitors. For more, see: Betting on Healthcare's Growth Engine.)

The Cure for What Clots You

Sanofi’s next biggest moneymaker is Plavix, one of the world’s most potent blood thinners. Plavix is cheap, with some American retailers offering it for as little as $0.40 a pill. If you’ve had a heart attack or a stroke, you’ve probably been prescribed Plavix. The patent on Plavix expired in the United States in 2012, knocking down revenue totals for what was once the second-best-selling drug in the world behind only arthritis anti-inflammatory prescription Humira.

Next up at the top of the Sanofi charts is Lovenox, which retails for about $8.00 per syringe and which Sanofi formulated to fight deep vein blood clots. It takes several million syringes to gross $1.8 billion, which Lovenox did for Sanofi in 2019.

No Prescription Required

Not all of Sanofi’s major moneymakers involve the development of a new molecule. The company’s over-the-counter offerings include some of the most mundane but important products sold in your standard drugstore aisle. The company’s burgeoning consumer health care division develops such sundries as Gold Bond powder, Rolaids, Selsun Blue dandruff shampoo, and many similar items. At the top of the consumer health care sales figures is Allegra, the allergy medication deemed most effective by multiple scientific studies. Allegra sales in Europe increased by an impressive 25% in 2019, bringing in $167 million across the globe. Sanofi’s next-best performing consumer health care item is Doliprane, a series of syllables that sounds unfamiliar in North America but which is the brand name of the company’s generic aspirin. The pain medicine segment grossed $1.6 billion in 2019. Consumer health care brought in a total of $6.1 billion last year.

As for generics, they brought in more than $1.4 billion million in 2019. Like all of Sanofi’s revenue and profit numbers, that income is subject to the caprices of the international currency markets. Sanofi reports in euro, which we’ve translated to dollar figures in the wake of an uncharacteristically high euro/dollar exchange rate over the last several reporting periods. (For more, see: The Bargain Stocks Leading the Next Trillion Dollar Industry.)

This Won’t Hurt A Bit

No self-respecting pharmaceutical giant is complete without a vaccines division, and Sanofi’s has contributed billions to the company’s coffers. Sales topped out at $7.5 billion in 2019. The two biggest vaccines the company sells have almost equal sales of about $2.5 billion each. The first is the standard flu vaccine. The second fights a three-front war against polio/whooping cough/haemophilus flu type B. Sanofi’s flu vaccine business increased more than 10% in 2019 and the combination vaccine increased 11%. The company’s other vaccines include meningitis/pneumonia, adult booster vaccines, and travel vaccines. To revamp an old saying, a few milligrams of prevention really are worth several dozen times that much in cure. (For related reading, see: JNJ vs. PG: Which is the Better Bet Right Now?)

The Bottom Line

Patient investors have enjoyed the ride since the company’s founding as the result of a 2004 merger, and most are staying put in anticipation of what the future will bring. (For more, see: Aging Population Feeds Global Healthcare Demand.)