Over the Pill
Welcome to “Over the Pill”, the Berenberg podcast where Kerry Holford & Luisa Hector lift the curtain on the messy reality of analysing pharma share prices. With over 30 years of friendship, Kerry & Luisa invite listeners into their regular debates on pharma strategy, drug pipeline prospects and commercial power.
Over the Pill
Episode 11
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With Q1 reporting season now underway, Luisa & Kerry run through key highlights from Sanofi and Roche results with a focus on longer dosing interval Dupixent. As usual obesity is in focus after CMS had to extend its Medicare bridge program to allow patients access from July after payers failed to opt-in on time.
Hi, I'm Louisa Hector.
SPEAKER_00And I'm Carrie Holford.
SPEAKER_01Welcome to Over the Pill, the weekly podcast on the latest hot topics in pharma investing. Right. What should we go through? Last week we published, didn't we?
SPEAKER_00We did. So last week we published our feedback note, Farmer on the Road, which we named All Talk and Some Action. So if you recall, it was our busiest schedule yet on the East Coast. And so yeah, we pulled together a little summary of the feedback we had, most discussed stocks, no Nordisk, AppB, and a bit also on AstraZeneca. But I wanted to just bring your attention back onto the Colonial Obesity names because last week was the first week of the US prescriptions for Liddy's foundation, the oral GLP one. The good news here for Novo is Wakovi pill scripts in that same week showed a nice gross tick up. Seems to be the market was somewhat disappointed with that first week. Of course, it's super early, so we're not reading anything into that. But I think the share price performance on Friday, Novo strongly up, nearly down, just reminds us how how focused is going to be on this weekly data. So far, so good for Novo.
SPEAKER_01And then we also had the Medicare update.
SPEAKER_00We did, which which I guess there was some anticipation of this because this is the update for the Medicare Balance Program that was due to start 1st of Jan next year, but it required at least 80% of covered lives to have been opted in by their healthcare payers. And we learned last week that CVS would not be opting in. United, we're speaking very sort of cautiously about this, both citing issues with drug utilization and not having enough data effectively at this point. So the government has stepped in, the the bridge programme has been extended from six months to 18 months. Balance will commence 1st of Jan 2028. And the government has agreed to share that utilisation data in the interim with the payers who now need to opt-in by the end of this year. So net net, I don't think it really makes an awful lot of difference. Medicare patients will be able to get obesity meds for the first time from the beginning of July, but the contract is different and the debate is clearly there between the payers and the government. In the meantime, the obesity um companies have been the best performance interest in the past.
SPEAKER_01Yeah, we've seen that shift now, clearly in the past month, obesity regaining some round, basically.
SPEAKER_00So that was um those bits. And last week Laman did a highlight, but you were also busy with results.
SPEAKER_01Yes, I had two sets of results last week, all on the same day, of course. Uh, Roche and Sanafi. Roche is sales only Q1. So it was it was fine. I mean, nothing to get too excited about. Um, big currency effect in the quarter, so that sort of dragged everything down a little. And I would say from the call, I probably the biggest topic was still the SERD. So we've had this several times now with our Battle of the Pills this year. So again, they were just trying to reinforce their confidence in Gerard Estrand. The LiDERA trial has been filed with a priority review voucher. We also have Evera, which was already filed, that has now a Padufa date in December. So both of those filings could be uh could be finalized and approved by the end of the year. And they were once again keen to highlight the opportunity for juridestrants in the adjuvant setting. They say overall uh CERTs have an opportunity, 20 to 30 billion, that's adjuvant and metastatic, but that adjuvant represents 70% of that. Uh, they were pushed a little on how much they think Lydera would cover of adjuvant. Um, they didn't commit specifically, but they say 25% of patients are on a CDK 4.6, and some of those drop off with the side effect issues. So really trying to reinforce the significant opportunity for duridest. Uh, but we are now waiting. The next action in the CERDs is the AstraZeneca ADCOM on the 30th of April. That's for the first line switch trial, Serena 6, and then Astra is due to have its first line data in all commas uh by the end of the year, Serena 4. So it's still those cards to turn. So Roche eventually pretty straightforward. Sanathy, that was better received, so good numbers, guidance reiterated, and we got a little bit more colour on plans for life cycle management of Dupixant. This had been promised at the Q4 results. So we got some colour. We've also had a little bit from Regeneron earlier in the year on the pipeline preclinical assets, etc., that will be following on from Dupi. Some of these involve Sanafi, some do not. So the new element really was a little bit more kind of firmer statements around the Dupey LOE. So this is something for US only. They said um we also had a cell side meeting with SANFI on Friday. So they said the LOE extension is not relevant to Europe or Japan. They said they are absolutely working in their internal planning with the original 2031 LOE date for Duby. But realistically, we could imagine that that could be extended anything from some zero to five years the time frame they would use. There are patents pending to 2045, but the message was zero to five years from 31. Uh, and that each year that they add is around 2 billion of cash flow that would be sort of additive to their internal planning. Now that's the LOE side, so that's just the IP. Then we had the colour on the longer active DP. So here we have a couple of options. We have a high dose, which would be asthma only, and then we have the coformulation. So this is with hyaluronidase, it confirmed that. And it's every four weeks dosing rather than every two, and that was about all we got. We don't know where the hyaluronidase is coming from, it's a partner they didn't specify, and they gave a little bit of colour, kind of bridging studies that would be required, but nothing too concrete in terms of timing. But if it's just bridging and kind of traditional pathways, it's relatively straightforward. So there was a lot of chatter around that. Um, so that was that was really the key points from Sanafi on Friday.
SPEAKER_00Okay, so now we look forward to this week. It's a busy one. Um we've got Nivas results on Tuesday, where it's probably still a little too early for the phase three data readouts that we're waiting for for this company. That's Pella Carlson, LP Lidley, Remy Brutene, S, and Del Desaran, the Ability product for DM1. So these are all really important readouts this year. But I suspect Q1 results is probably still a little early to anticipate any of those. Um, later in the week, Wednesday, we've got the UK names, Astra, GSK, also AB and Regeneron, so important there for the reader cross for Santa Vee. And Thursday, Bristol, Murp, Lily, and Amgen again for readacross. So it's a busy one. Um it is, which jump yeah, lots to do.
SPEAKER_01So I've realized I also need to go and prepare a little bit more for all of these. So we'd better get back to the test. Let's do it. So we'd love to hear your feedback and requests. Feel free to email us at luisa.hecta or carrie dotholford at Bramberg.com. And thank you for listening to you.