David W

$LLY TZP growth in absolute number is Multiple folds of combined orals from Lilly and $NVO Zepbound TRx was up +8% w/w and NRx were up +11% w/w, respectively, with TRx ending the week at ~710k vs. the prior week's ~659k. •Wegovy TRx were up +8% w/w and NRx were up +13% w/w, respectively, with TRx ending the week at ~326k vs. the prior week's ~301k. Inj. TRx for Diabetes (M+O) were up +5% w/w. •Mounjaro TRx were up +6% w/w and NRx were up +8% w/w, respectively, with TRx ending the week at ~828k vs. the prior week's ~784k. •Ozempic TRx were up +4% w/w and NRx were up +6% w/w, with TRx ending the week at ~505k vs. the prior week's ~485k.

This is incorrect article. Medicare population that qualifies is much higher than this and the program is a huge push for both $LLY and $NVO. It could actually save novo so its investors should thank US admin for that. But will probably be gradual. Although I expect big initial wave. Will benefit other obesity biotech value $VKTX $KLRA

TRIUMPH-3. Less exciting and maybe disappointing? Across both placebo and treatment arms, they ran into reduced rates of MACE than expected, which is problematic for a CVD trial. ▪️22.6% WL (12mg), 21.6% WL (9mg), 3.2% (placebo) ▪️On Treatment MACE-3 - Hazard ratio = 0.92 95.0% CI: 0.51 to 1.65; In study HR went up to 1.22 ▪️On treatment MACE-5 - Hazard ratio = 0.73 95.0% CI: 0.47 to 1.12; In study HR went up to 1.12 “In the study, major adverse cardiovascular events (MACE) occurred less frequently than anticipated in both retatrutide and placebo arms. In pre-specified analyses for time to first occurrence of MACE, there were 44 MACE-5 (all-cause death, heart attack, stroke, heart failure event, or coronary revascularization) events observed in participants randomized to retatrutide (pooled 9 mg and 12 mg) and 52 events observed in those randomized to placebo… There were 27 MACE-3 (cardiovascular death, heart attack, or stroke) events in participants randomized to retatrutide and 23 in those randomized to placebo.”

At wk 28 $RHHBY Ct388 achieved 15% wt loss by efficacy estimand vs $LLY TZP 16% at wk 28. Then ct388 continues to cause further wt loss but all by efficacy estimand. We really don’t know what happened. Treatment estimand is much lower ? We don’t know placebo wt loss for treatment estimand ? It is not due to escalation rate as similar time wise for both molecules . I got a feeling Roche doesn’t have deep expertise in obesity when it comes to evaluating M&A targets or when reporting trials or even designing protocols ?

🚨TRIUMPH-2 and -3 topline results are out for retatrutide. TRIUMPH-2 was a weight loss trial in T2D patients, while TRIUMPH-3 enrolled a mix of patients with established cardiovascular disease w/ or w/o T2D and a min BMI of 35. The GREAT: ▪️TRIUMPH-2: Weight loss - 20.8% (12mg), 19.1% (9mg), 12.7% (4mg), 4.0% Placebo Those are HUGE numbers for diabetics. For comparison, SURMOUNT-2 with tirzepatide saw an average loss of 15.7% for 15mg and that was a giant step up from STEP-2 for Semaglutide (10.6%). Speaking of stepping up, STEP UP T2D for Semaglutide hit 13.2%. The not so great: ▪️TRIUMPH-2: A1C reduction between 1.6% and 1.4% with a baseline of 7.7%. All WL/A1C numbers are efficacy estimands. TRANSCEND-T2D-1 saw 2.0% reduction in 40 weeks with no metformin or other glucose lowering meds. TRIUMPH-2 required patients to be on a stable diabetes treatment for 90 days prior.