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In addition: Generic tafamidis is arriving in Europe, and France has published the first price. France: the Journal officiel (28 Oct) set Tafamidis Zydus 61mg at €1,088 per box of 30 (€935.47 ex-factory), effective 1 Nov. That's ~83% lower than branded. More are lined up in France. Viatris, Zentiva, EG and Biogaran all have hospital/pharmacy codes registered, and patient groups say generics can be marketed from 19 Nov. Prices for those four haven't been published yet. Generics are approved for hereditary ATTR-CM only. Vyndaqel keeps orphan exclusivity in wild-type, the large majority of patients, until Feb 2030. But expect European payers to push generic use as hard as the rules allow, and watch for leakage into wild-type. Germany: no generic is listed in public pharmacy databases yet, but Accord's is approved EU-wide, and Adalvo and Welding hold European approvals that likely include Germany. Generics can price freely at launch. The bigger lever is a Festbetrag (reference price). Once generics are on the market, the G-BA can form a Stufe 1 group for the same active ingredient. Orphan status doesn't block this: sapropterin got a Stufe 1 group in April 2026. Key precedent: the G-BA and the BSG (2018) treat Stufe 1 groups as active-ingredient-based and, as a rule, ignore approved indications. The G-BA has rejected "no alternatives in the group" arguments before (etanercept, zoledronic acid). Pfizer has already moved: in August it launched a Vyndaqel 61mg film-coated tablet in Germany, approved for wild-type only, at the same €11,128 price. Pfizer says ~96% of German patients are wild-type. Can the tablet be pulled into a reference price group? On precedent, likely yes. The G-BA routinely groups "oral dosage forms" together (abiraterone covers film-coated and plain tablets), and only therapy-relevant bioavailability differences count. Pfizer says tablet ≈ capsule. G-BA consultation plus GKV-Spitzenverband price-setting typically takes months after generics launch, and a tablet script can't be swapped for a generic capsule in the meantime. Obviously this impacts $PFE and Bayer more directly, but it's a headwind for $BBIO's European royalties too. $BBIO sold 60% of its European royalties on the first $500M of annual Beyonttra sales, so much of the near-term exposure sits with the royalty buyers. The bigger risk for BBIO is the tranche it fully keeps: if price erodes, Beyonttra may take much longer to get above $500M, or never get there. Tail risk: BBIO signed an MFN deal with the administration in Aug 2026. If MFN expands and benchmarks against European acoramidis pricing, cheaper tafamidis dragging down Beyonttra's price could eventually pull down Attruby's US price.

Need to be above consensus for current valuation to make sense and I think they will burn a bunch of cash prosecuting label expansion + ARQ-234 is probably uncompetitive?