Refining Value

Bluesky has seen a surge lately and increasingly feels like the old Twitter while this place increasingly feels broken

There's now 10 Humira biosimilars on the US market priced at 80+% off the brand name version (and 7 at 85+% off) ...and $ABBV still controls 77% of the market...

@BertrandBio @biobrainbox Agree. Pricing unlikely to change w inc PoS. I think risk for Eur (generalizing) is as US-Eur opportunity diff increases, the oft-higher Eur evidence reqs will increasingly not be worth it, especially when it comes to Ph3. Eur will be forced to lower bar or forego access@ margin

@biobrainbox I'm not sure why POS would impact the drug pricing. What do you have in mind? Less pressure on commercial pipe allowing some tradeoffs? As it stands, I'd simply expect higher top & bottom line with no or little change on pricing considerations.

$NVS $SAN $SNY Pharma bosses call for higher drug prices in EU to counter tariff threat That's not to counter tariffs, that's a general request, and in case Trump moves to align Medicare/Medicaid prices with Europe. And $NVS Vas, $SAN $SNY Paul, or $AZN Pascal were already out with that same narrative on Europe losing attractiveness well before tariffs were even a thing. Weirdly, this letter comes the day after rumors of Trump thinking to align prices with Europe... ft.com/content/8c66da…

Nice slide from $BMY on Medicare Part D redesign - valid for all the BigP but impact dpding on overall exposure to this market segment

@Sports_bios @bradloncar On "malignant competition" it has always been there, no? You just have cheaper options for inlicensing now, improving the economics rather than worsening. To me that is the one trend acting against everything else you mentioned. Still an uphill battle

The industry is maturing and having real issues to break thru the mindset of - gee - we have 60B revenue topline - and even a boring 5% growth - that means 3B organic growth (assuming no LOE - and you know that's impossible) - and have to keep compounding this math with even bigger topline down the road - .. hitting a 2B peak sales drug candidate is more luck than skill - and they have to do that at increasing frequency - compounding is the 8th wonder of the world and a beast not to be beaten easily - .. and a 5% growth - wallst yawns - .. sure, obesity has the big growth now - but that mkt will mature one day - and then what - esp. w. LLY/NVO trading at unsustainable multiples - .. the pricing pressure from govn policies is another compressor of the valuation multiples - ex-US mkt - which country is willing to pay more on drug prices - I don't see it - .. and yes, the rise of malignant competition - domestic or abroad - .. one drug tgt then have dozens of people swamping there in no time - big waste of time and financial/human capital - they know this, but they have to keep doing this - just to keep the giant snowball on the topline to keep the compound growth (and hope and pray the whole thing won't fall apart) - .. jmho.

After going through earnings this week, I was thinking that I probably wouldn’t recognize half of the current crop of big pharma CEOs if they were sitting next to me in a plane right now. These are some seriously unexciting stories lately.

Interesting comment on GLP-1s in Parkinsons: “’We should know by now that it’s extremely rare that a drug just happens to treat a disease, if not designed for it”. And obvious reply is that we do know failure is extremely common for diseases that a drug IS designed for it. 1/n

Today I am thinking of the people I’ve met around the world—children, parents, health workers, teachers—who will be harmed by the Trump administration’s decision to try to dismantle USAID and walk back U.S. leadership in global health and poverty reduction. I’m thinking, too, about the dangerous ripple effects this will cause. In an increasingly interconnected world, we’re all better off when lifesaving medicines are developed and delivered, when disease outbreaks are halted, and when nations lift themselves out of poverty. Strong leaders throughout history have understood that foreign aid builds a heathier, safer, more prosperous world—and that’s a goal everyone should be able to get behind.

@Biohazard3737 Is the bulk of the societal value the industry produces in the hiring it does or the drugs it discovers? If societal value is the aim then why does it matter where discovery etc happen? A good amount of development spend will happen in the US anyway given the site-driven costs

@varma_ashwin97 @Frank_S_David PCSK9i trials even worse (larger n, longer follow up, and an argument that OO and FOURIER didn't show the full benefit because f/u wasn't long enough). $NVS ORION-4 will also be worse than Entresto CVOT

Example of interpreting announced delay of an event-driven clinical trial —>

In other words, executive branch is meant to get checked and balanced, arguably here. Of course no "right" answer for a given issue including this one.

I think it's a fair take but Senate was also partly created for and has a long history of blunting large and sudden swings driven by popular opinion. Can argue to do what the founders intended of it (and thereby government as a whole) Senate has a responsibility to not confirm

Some interesting parallels re Deepseek: US-based LLMs and the bio explosion in China:US biotech Still feel it'll be net positive for the industries and consumers at large in both cases

We have moved... We have decided to take a break from X, but we want to keep talking about medicines and public & animal health with all of our followers. Find us on Bluesky ➡️ EMA-EU.bsky.social

I shouldn't try to apply logic here and apologies for the rare political post but if NIH is developing all of the drugs then why are we freezing all of the funding again?

Looking forward to this. Love the premise and can't think of anyone better for it

Interesting that Leerink now has a team doing independent cost effectiveness analyses. Seems to be taking more of a GCEA approach. An alternative to ICER? leerink.com/article/a-cpe-…

@matthewherper @michael_gilman @afinley @DShaywitz Would've been up there with Sanofi paying to get out of aflibercept eye development inherited from Aventis..

@michael_gilman @afinley @DShaywitz entirely -- and didn't know what they had until Bristol presented its data. It's said they were about to sell it for a song!

A pretty smart take here, from investor Simos Simeonidis, on the Pfizer/Starboard fracas. His conclusion? He thinks the chances of Starboard prevailing are "very low." linkedin.com/posts/activity…

Prior post on the dementia "effect" studies here refiningvalue.substack.com/p/real-world-b…

Been saying this with all of the GLP RWE. Good hypothesis generation for sure but let's not forget how hard it is to measure / adjust for confounding in these data pts w GLP-1 access fundamentally different - higher SES, education etc

Laudable goal to improve trial data collection efficiency but I'm not sure how it is diff than existing alts and ultimately faces same ? of whether it's actually replacing any trial collection/cost or just adding on. But it's Abernathy so worth paying attn to. 🤞something here