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Exhibit 10.18.1

EXECUTION COPY
AMENDMENT NO. 1
Dated as of November 11, 2021
to
CREDIT AGREEMENT
Dated as of December 14, 2018
THIS AMENDMENT NO. 1 (this “Amendment”) is made as of November 11, 2021 by and among Regeneron Pharmaceuticals, Inc., a New York corporation (the “Company”), Regeneron Healthcare Solutions, Inc., a New York corporation (“Solutions”), and Regeneron Genetics Center LLC, a Delaware limited liability company (“Genetics” and together with the Company and Solutions, the “Borrowers”), the financial institutions listed on the signature pages hereof and JPMorgan Chase Bank, N.A., as Administrative Agent (the “Administrative Agent”), under that certain Credit Agreement dated as of December 14, 2018 by and among the Borrowers, the Lenders and the Administrative Agent (as amended, restated, supplemented or otherwise modified from time to time, the “Credit Agreement”).  Capitalized terms used herein and not otherwise defined herein shall have the respective meanings given to them in the Credit Agreement.
WHEREAS, the Company has requested that the requisite Lenders and the Administrative Agent agree to a certain amendment to the Credit Agreement;
WHEREAS, the Borrowers, the Lenders party hereto and the Administrative Agent have agreed to amend the Credit Agreement on the terms and conditions set forth herein;
NOW, THEREFORE, in consideration of the premises set forth above, the terms and conditions contained herein, and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the Borrowers, the Lenders party hereto and the Administrative Agent hereby agree to enter into this Amendment.
1.Amendments to the Credit Agreement.  Effective as of the date of satisfaction of the conditions precedent set forth in Section 2 below, the parties hereto agree that the Credit Agreement is hereby amended as follows:
(a)Section 1.01 of the Credit Agreement is hereby amended to insert the following definition therein in the appropriate alphabetical order as follows:
“Amendment No. 1 Effective Date” means November 11, 2021.
(b)Section 1.01 of the Credit Agreement is hereby amended to restate the definition of “Agreed Currencies” appearing therein in its entirety as follows:
“Agreed Currencies” means (i) Dollars and (ii) any other currency (x) that is a lawful currency (other than Dollars) that is readily available and freely transferable and convertible into Dollars and (y) (1) with respect to Loans, that is agreed to by the Administrative Agent and each of the Lenders and (2) with respect to Letters of Credit, that is agreed to by the Administrative and the applicable Issuing Bank.  For the avoidance of doubt, it is understood and agreed that on and after the Amendment No. 1 Effective Date, the only Agreed Currency with respect to Loans shall be Dollars (notwithstanding any references in this Agreement to any other currency) and no additional currency shall be included as an Agreed Currency with respect to Loans until such currency is requested by the Company and approved by the Administrative Agent 

and each of the Lenders pursuant to an amendment to this Agreement mutually satisfactory to the Company, the Administrative Agent and each of the Lenders.
(c)The definition of “Interest Period” set forth in Section 1.01 of the Credit Agreement is hereby amended to replace the reference to “one, two, three or six months (or, if reasonably satisfactory to the Administrative Agent and each of the Lenders, such other period) thereafter” appearing therein with a reference to “one, three or six months (or, if reasonably satisfactory to the Administrative Agent and each of the Lenders, such other period) thereafter” therefor.
2.Conditions of Effectiveness.  The effectiveness of this Amendment is subject to the conditions precedent that the Administrative Agent shall have received (i) counterparts of this Amendment duly executed by the Borrowers, the Required Lenders and the Administrative Agent and (ii) payment and/or reimbursement of the Administrative Agent’s and its affiliates’ reasonable and documented out-of-pocket fees and expenses (including, to the extent invoiced, reasonable fees and expenses of counsel for the Administrative Agent) in connection with the Loan Documents.
3.Representations and Warranties of the Borrowers.  Each Borrower hereby represents and warrants as follows:
(a)This Amendment and the Credit Agreement as modified hereby constitute legal, valid and binding obligations of such Borrower, enforceable against such Borrower in accordance with their respective terms, subject to (i) applicable bankruptcy, insolvency, examinership, reorganization, moratorium or other laws affecting creditors’ rights generally, (ii) general principles of equity, regardless of whether considered in a proceeding in equity or at law and (iii) requirements of reasonableness, good faith and fair dealing.
(b)As of the date hereof and immediately after giving effect to this Amendment, (i) no Event of Default or Default has occurred and is continuing and (ii) the representations and warranties of such Borrower set forth in the Credit Agreement (excluding the representations and warranties set forth in Sections 3.04(b) and 3.06(a) of the Credit Agreement), as amended hereby, are true and correct in all material respects (or, in the case of any representation or warranty qualified by materiality or Material Adverse Effect, in all respects), except to the extent that such representations and warranties specifically refer to an earlier date, in which case they are true and correct in all material respects (or, in the case of any representation or warranty qualified by materiality or Material Adverse Effect, in all respects) as of such earlier date.
4.Reference to and Effect on the Credit Agreement.
(a)Upon the effectiveness hereof, each reference to the Credit Agreement in the Credit Agreement or any other Loan Document shall mean and be a reference to the Credit Agreement as amended hereby.
(b)Each Loan Document and all other documents, instruments and agreements executed and/or delivered in connection therewith shall remain in full force and effect and are hereby ratified and confirmed.
(c)The execution, delivery and effectiveness of this Amendment shall not operate as a waiver of any right, power or remedy of the Administrative Agent or the Lenders, nor constitute a waiver of any provision of the Credit Agreement, the Loan Documents or any other documents, instruments and agreements executed and/or delivered in connection therewith.
(d)This Amendment is a Loan Document under (and as defined in) the Credit Agreement.
5.Governing Law.  This Amendment shall be construed in accordance with and governed by the laws of the State of New York.
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6.Headings.  Section headings in this Amendment are included herein for convenience of reference only and shall not constitute a part of this Amendment for any other purpose.
7.Counterparts.  This Amendment may be executed by one or more of the parties hereto on any number of separate counterparts, and all of said counterparts taken together shall be deemed to constitute one and the same instrument.  The words “execution,” “signed,” “signature,” “delivery,” and words of like import in or relating to this Amendment and/or any document to be signed in connection with this Amendment and the transactions contemplated hereby shall be deemed to include Electronic Signatures (as defined below), deliveries or the keeping of records in electronic form, each of which shall be of the same legal effect, validity or enforceability as a manually executed signature, physical delivery thereof or the use of a paper-based recordkeeping system, as the case may be.  As used herein, “Electronic Signatures” means any electronic symbol or process attached to, or associated with, any contract or other record and adopted by a person with the intent to sign, authenticate or accept such contract or record.
[Signature Pages Follow]
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IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be duly executed and delivered by their respective authorized officers as of the day and year first above written.
			
	REGENERON PHARMACEUTICALS, INC.,
as the Company

	
	By: /s/ Leonard Brooks                                         

	Name:    Leonard Brooks
	Title:    Vice President, Treasurer

Signature Page to Amendment No. 1 to
Credit Agreement dated as of December 14, 2018
Regeneron Pharmaceuticals, Inc.

			
	REGENERON HEALTHCARE SOLUTIONS, INC.,
as a Subsidiary Borrower

	
	By: /s/ Marion McCourt                                         

	Name:    Marion McCourt
	Title:    General Manager

Signature Page to Amendment No. 1 to
Credit Agreement dated as of December 14, 2018
Regeneron Pharmaceuticals, Inc.

			
	REGENERON GENETICS CENTER LLC,
as a Subsidiary Borrower

	
	By: /s/ Leonard Brooks                                         

	Name:    Leonard Brooks
	Title:    Treasurer

Signature Page to Amendment No. 1 to
Credit Agreement dated as of December 14, 2018
Regeneron Pharmaceuticals, Inc.

			
	JPMORGAN CHASE BANK, N.A.,
individually as a Lender and as Administrative Agent

	
	By: /s/ Gregory T. Martin                                           

	Name:    Gregory T. Martin
	Title:    Executive Director

Signature Page to Amendment No. 1 to
Credit Agreement dated as of December 14, 2018
Regeneron Pharmaceuticals, Inc.

			
	Name of Lender:

U.S. Bank, National Association                       

	
	By: /s/ Michael West                                                     

	Name:    Michael West
	Title:    Senior Vice President

Signature Page to Amendment No. 1 to
Credit Agreement dated as of December 14, 2018
Regeneron Pharmaceuticals, Inc.

			
	CITIBANK, N.A.,
as a Lender

	
	By: /s/ Eugene Yermash                                               

	Name:    Eugene Yermash
	Title:    Vice President

Signature Page to Amendment No. 1 to
Credit Agreement dated as of December 14, 2018
Regeneron Pharmaceuticals, Inc.

			
	FIFTH THIRD BANK, NATIONAL ASSOCIATION,
as a Lender

	
	By: /s/ Shailesh Patel                                               

	Name:    Shailesh Patel
	Title:    Managing Director

Signature Page to Amendment No. 1 to
Credit Agreement dated as of December 14, 2018
Regeneron Pharmaceuticals, Inc.

			
	MUFG BANK, LTD.,
as a Lender

	
	By: /s/ Jack Lonker                                              

	Name:    Jack Lonker
	Title:    Director

Signature Page to Amendment No. 1 to
Credit Agreement dated as of December 14, 2018
Regeneron Pharmaceuticals, Inc.

			
	BARCLAYS BANK PLC,
as a Lender

	
	By: /s/ Arvind Admal                                              

	Name:    Arvind Admal
	Title:    Vice President

Signature Page to Amendment No. 1 to
Credit Agreement dated as of December 14, 2018
Regeneron Pharmaceuticals, Inc.

			
	GOLDMAN SACHS BANK USA,
as a Lender

	
	By: /s/ Dan Martis                                                         

	Name:    Dan Martis
	Title:    Authorized Signatory

Signature Page to Amendment No. 1 to
Credit Agreement dated as of December 14, 2018
Regeneron Pharmaceuticals, Inc.

			
	THE NORTHERN TRUST COMPANY,
as a Lender

	
	By: /s/ Eric Siebert                                                         

	Name:    Eric Siebert
	Title:    Senior Vice President

Signature Page to Amendment No. 1 to
Credit Agreement dated as of December 14, 2018
Regeneron Pharmaceuticals, Inc.

			
	THE GOVERNOR AND COMPANY OF THE BANK
OF IRELAND,
as a Lender

	
	By: /s/ Christopher Dick                                                 

	Name:    Christopher Dick
	Title:    Deputy Manager

	
	By: /s/ Keith Hughes                                                       

	Name:    Keith Hughes
	Title:    Director, Corporate Banking

Signature Page to Amendment No. 1 to
Credit Agreement dated as of December 14, 2018
Regeneron Pharmaceuticals, Inc.

			
	PNC BANK, NATIONAL ASSOCIATION,
as a Lender

	
	By: /s/ Robert M. Martin                                                         

	Name:    Robert M. Martin
	Title:    Senior Vice President

Signature Page to Amendment No. 1 to
Credit Agreement dated as of December 14, 2018
Regeneron Pharmaceuticals, Inc.

			
	CITIZENS BANK, N.A.,
as a Lender

	
	By: /s/ Mark Guyeski                                                         

	Name:    Mark Guyeski
	Title:    Vice President

Signature Page to Amendment No. 1 to
Credit Agreement dated as of December 14, 2018
Regeneron Pharmaceuticals, Inc.Document

Exhibit 10.20.1

CERTAIN CONFIDENTIAL PORTIONS OF THIS EXHIBIT, MARKED BY BRACKETS, WERE OMITTED BECAUSE THOSE PORTIONS ARE NOT MATERIAL AND WOULD BE COMPETITIVELY HARMFUL TO THE COMPANY IF PUBLICLY DISCLOSED.
    

FIRST AMENDMENT TO IMMUNO-ONCOLOGY LICENSE AND COLLABORATION AGREEMENT
THIS FIRST AMENDMENT TO IMMUNO-ONCOLOGY LICENSE AND COLLABORATION AGREEMENT (this “First Amendment”), dated as of October 6, 2021 (the “Execution Date”) and effective as of September 30, 2021 (the “Effective Date”), is by and between Sanofi Biotechnology SAS, a sociéte par actions simplifiée, organized under the laws of France, having a principal place of business at 54, rue La Boétie, 75008 Paris, France (“Sanofi”) and Regeneron Pharmaceuticals, Inc., a corporation organized under the laws of the state of New York and having a principal place of business at 777 Old Saw Mill River Road, Tarrytown, New York 10591 (“Regeneron”) (with each of Sanofi and Regeneron being sometimes referred to herein individually as a “Party” and collectively as the “Parties”). 
 RECITALS
WHEREAS, Regeneron and Sanofi are parties to that certain Immuno-Oncology License and Collaboration Agreement dated as of July 1, 2015 (the “IO LCA”) for the Development, Manufacture and Commercialization of Licensed Products (as such terms are defined therein); 
WHEREAS, Regeneron and Sanofi are parties to a letter agreement dated as of January 7, 2018 that, among other things, amended certain terms of the IO LCA (the “January 2018 Letter”); and
WHEREAS, the Parties desire to amend the IO LCA to set forth certain terms and conditions regarding the Co-Commercialization by the Parties of the Licensed Product known as Libtayo (“Libtayo”).
NOW, THEREFORE, in consideration of the following mutual covenants contained herein, and for other good and valuable consideration the adequacy and sufficiency of which are hereby acknowledged, the Parties agree as follows: 
AGREEMENT
1.Definitions.
1.1.All capitalized terms used in this First Amendment which are not otherwise defined herein shall have the meanings ascribed to them in the IO LCA.  
1.2.The definition of “Commercial Overhead Charge” in Section 1.20 of the IO LCA is hereby amended by deleting the last sentence of such definition and replacing it with the following: “For the avoidance of doubt, ‘Commercial Overhead Charge’ shall not include any amounts otherwise included in Shared Commercial Expenses (unless included solely pursuant to clause (i) thereof) or Other Shared Expenses.”
2.Acknowledgements and Agreements.  Solely with respect to Libtayo, the Parties acknowledge and agree as follows:
2.1.    Increase of the REGN2810 Budget Amount.

(a)The REGN2810 Budget Amount shall be increased by $200,000,000 from $1,640,000,000 (the “Former Cap”) to $1,840,000,000. The REGN2810 Budget Amount shall mean one billion eight hundred forty million dollars ($1,840,000,000).
(b)The $200,000,000 increase shall be shared equally between the Parties (i.e., $100,000,000 each).
(c)For the avoidance of doubt, in accordance with Section 5.3(b) of the IO LCA, Sanofi shall not be obligated to reimburse Development Costs in excess of this revised REGN2810 Budget Amount.
(d)Regeneron shall complete [* * *]. For the avoidance of doubt, [* * *], REGN shall incur any and all costs and expenses required to complete [* * *]. In the event that Regeneron incurs any costs and expenses in excess of the REGN2810 Budget Amount, such excess costs and expenses shall be borne exclusively by Regeneron and shall not be counted toward the Development Cost True-Up as set forth on Schedule 2 of the IO LCA.       
(e)[* * *].
2.2    REGN2810 Global Development Plan and REGN2810 Global Development Budget.
(a) As a result of the increase in the REGN2810 Budget Amount (from $1,640,000,000 to $1,840,000,000), each of the REGN2810 Global Development Plan and the REGN2810 Global Development Budget [* * *] are set forth in Schedule I to the IO Side Letter and such Schedule I shall (i) replace and supersede Part A of the January 2018 Letter and (ii) be deemed an integral part of the IO LCA.
(b)Notwithstanding anything to the contrary in the IO LCA, but subject to Section 2.2(c) below, as from the Effective Date: 
(i)Regeneron shall not [* * *] without Sanofi’s prior written consent, such consent not to be unreasonably withheld or delayed; and
(ii)Regeneron shall not [* * *], except as agreed by the Parties.
(c)For the avoidance of doubt, [* * *].  
2.3.    Disbursement of Sanofi’s Share of the $200M Increase.
(a)Subject to the foregoing and subject to the REGN2810 Budget Amount, Sanofi’s obligation to reimburse 50% of the Development Costs incurred by Regeneron in excess of the Former Cap shall be capped at $100,000,000 in total irrespective of the amount of Development Costs actually incurred by Regeneron in excess of the Former Cap to complete [* * *].
(b)Subject to the foregoing and subject to the REGN2810 Budget Amount,  in Contract Year 2023 Sanofi shall not be obligated [* * *].  Any Development Cost for REGN2810 incurred by Regeneron in excess of such amount [* * *]; provided, however, that Sanofi shall not be obligated to reimburse Development Costs in excess of the revised REGN2810 Budget Amount.     
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(c)In the event that REGN2810 Development Costs exceed $1,640,000,000 before December 31st, 2022, any such amounts will be repaid consistent with section (b) above. 
(d)Notwithstanding anything to the contrary in Section 5.3(b) of the IO LCA or Part I (4)(b) of the January 2018 Letter, between the Parties, the REGN2810 Global Development Budget [* * *].  In addition, twice each Contract Year during the Term, Regeneron will provide Sanofi with a good-faith forecast of anticipated Development Costs to be incurred for REGN2810 each year for the remainder of the Term, with such forecasts [* * *].  
2.4.    US Commercialization.
(a)Out-of-Pocket Costs for Commercialization of Libtayo in the United States [* * *] shall be allocated [* * *]. Such allocation of Out-of-Pocket Costs for Commercialization of Libtayo shall be referred to as the “OOP Allocation”. [* * *].
(b)The OOP Allocation will be [* * *].
(c)The allocation of US Commercial Overhead FTEs for Libtayo in the United States [* * *], unless otherwise agreed by the Parties.     
(d)For the purposes of this subsection, “US Commercial Overhead FTE” means: those [* * *].   
2.5.    ROW Commercial Overhead FTE.
(a)In any Co-Commercialization Country in the ROW Territory (other than any Sales Force Intensive Country), Regeneron’s ROW Commercial Overhead FTEs in such country [* * *].  In any Co-Commercialization Country in the ROW Territory for Libtayo with [* * *] (such countries, “Sales Force Intensive Countries”), Regeneron’s ROW Commercial Overhead FTEs [* * *].
(b)“ROW Commercial Overhead FTEs” means, with respect to Regeneron and in Co-Commercialization Countries in the Rest of World, [* * *].  
2.6.    Data Sharing. Clinical databases and the available supportive Metadata Documents will be exchanged for all studies conducted by a Party or its Affiliates pursuant to the REGN2810 Global Development Plan at the time of completion of interim or final KRM/CSRs. Similarly, integrated datasets arising from studies conducted by a Party or its Affiliates pursuant to the REGN2810 Global Development Plan used to support any marketing application will be exchanged at the time of completion of the Integrated Summary Reports; provided that, Sanofi shall provide Regeneron the opportunity to review and approve (such approval not to be unreasonably withheld) any submission to a Regulatory Authority or any proposed publication that contains data from such a database or any new analyses of such data that have not been previously filed.  For purposes of this Section 2.6, (a) “Metadata Document” means a data definition file that describes the format and content of the data sets.  For clarity, in CDISC standards, which all submission datasets need to follow, the metadata are stored in a document called Define.XML. and (b) “Integrated Summary Report” means the integrated summary of efficacy (ISE) and the integrated summary of safety (ISS).
3.Acknowledgements and Agreements with respect to Timing of Approval of Global Commercialization Plans and Country/Region Commercialization Plans
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3.1.    Section 6.2(a) of the IO LCA is hereby amended by deleting the third sentence of such section and replacing it with the following:  “Such Global Commercialization Plan for each subsequent Contract Year shall be amended by the JCC and approved by the IOSC prior to [* * *].”
3.2.    Section 6.2(b) of the IO LCA is hereby amended by deleting the third sentence of such section and replacing it with the following:  “Such U.S. Commercialization Plan for each subsequent Contract Year shall be amended by the JCC and approved by the IOSC prior to [* * *].”
3.3.    Section 6.2(c) of the IO LCA is hereby amended by deleting the third sentence of such section and replacing it with the following:  “Such ROW Commercialization Plan for each subsequent Contract Year shall be amended by the JCC and approved by the IOSC prior to [* * *].”
3.4    Section 6.2(d) of the IO LCA is hereby amended by deleting the third sentence of such section and replacing it with the following:  “Such Country/Region Commercialization Plan for each subsequent Contract Year shall be amended by the applicable Country/Region Commercialization Committee, and approved by the JCC and the IOSC prior to [* * *].”
4.Miscellaneous Provisions.
4.1.    Due Organization, Valid Existence and Due Authorization.  Each Party represents and warrants to the other Party, as of the Effective Date, as follows:  (a) it is duly organized and validly existing under the Laws of its jurisdiction of incorporation; (b) it has full corporate power and authority and has taken all corporate action necessary to enter into this First Amendment; (c) the execution of this First Amendment will not constitute a breach of, or conflict with, its organizational documents or any other agreement by which it is bound or requirement of applicable Laws or regulations; and (d) this First Amendment is its legal, valid and binding obligation, enforceable in accordance with the terms and conditions hereof (subject to applicable Laws of bankruptcy and moratorium). 
4.2.    Miscellaneous.  The provisions of Sections 20.1, 20.3, 20.5, 20.6, 20.7, 20.10, 20.11 and 20.16 of the IO LCA shall apply mutatis mutandis to this First Amendment as though set out in full in this First Amendment.
4.3.    No Other Amendments.  Except as expressly amended hereby, all of the terms and conditions of the IO LCA shall remain in full force and effect.
[Signature Page Follows]
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IN WITNESS WHEREOF, Sanofi and Regeneron have caused this First Amendment to be executed by their duly authorized representatives as of the Execution Date.

SANOFI BIOTECHNOLOGY SAS

By    /s/ Alban de La Sablière        
    Name: Alban de La Sablière
    Title: President

REGENERON PHARMACEUTICALS, INC.

By    /s/ Kerry Reinertsen            
    Name: Kerry K. Reinertsen, Ph.D.
    Title: Senior Vice President, Strategic Alliances
[Signature Page to First Amendment to Immuno-Oncology License and Collaboration Agreement]

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