Puma in­vestors fret, as Ner­l­ynx Q1 sales fall un­com­fort­ably short of Wall Street es­ti­mates

“We are not pleased with our first-quar­ter Ner­l­ynx rev­enues,” Puma Biotech­nol­o­gy chief Alan Auer­bach said in a post-earn­ings con­fer­ence call on Thurs­day, cit­ing a spate of dis­con­cert­ing fac­tors, in­clud­ing pa­tient dis­con­tin­u­a­tions. In­vestors con­curred with his as­sess­ment, as the stock $PBYI cratered. The dis­dain con­tin­ued ear­ly Fri­day, as shares fell near­ly 37% to $18.96 be­fore the bell.

Alan Auer­bach

The drug, which was in-li­censed by Puma from Pfiz­er $PFE, was ap­proved by the FDA in Ju­ly 2017, to pre­vent breast can­cer re­lapse, fol­low­ing ther­a­py in pa­tients with HER2-pos­i­tive can­cer. The treat­ment is known to have a poor tol­er­a­bil­i­ty pro­file, pre­dom­i­nant­ly re­lat­ing to di­ar­rhea. The Los An­ge­les-based com­pa­ny post­ed Q1 Ner­l­ynx sales of $45.6 mil­lion — a 25% de­cline quar­ter-over-quar­ter — and well be­low Street con­sen­sus ex­pec­ta­tions of about $67 mil­lion.

“The dis­con­tin­u­a­tions oc­cur more fre­quent­ly in the first month. While most physi­cians pre­scribe an an­ti-di­ar­rheal med­ica­tion with Ner­l­ynx, our re­search shows that some pa­tients may not fill the an­ti-di­ar­rheal pre­scrip­tion. There were al­so some physi­cians not pre­scrib­ing any an­ti-di­ar­rheal pro­phy­lax­is med­ica­tions at all, which we be­lieve was due to the lack of aware­ness of the da­ta from our con­trol tri­al us­ing pro­phy­lac­tic an­ti-di­ar­rheal drugs,” Puma CCO Steven Lo said on the call.

Steven Lo

Oth­er rea­sons for the sales miss were at­trib­uted to: pa­tient dis­con­tin­u­a­tions ow­ing to the pro­gres­sion of the dis­ease, or loss of in­sur­ance; an ab­nor­mal­ly high va­can­cy rate in the sales force, with 18 of 80 sales ter­ri­to­ries en­dur­ing turnover dur­ing the quar­ter; and pa­tients com­plet­ing one year of treat­ment on Ner­l­ynx as in­di­cat­ed on the la­bel.

“The neg­a­tive im­pact from treat­ment dis­con­tin­u­a­tions di­rect­ly re­lat­ed to Ner­l­ynx’s chal­leng­ing tol­er­a­bil­i­ty pro­file, which has seem­ing­ly had a re­laps­ing/re­mit­ting im­pact on quar­ter­ly com­mer­cial re­sults, was ex­plic­it­ly de­scribed as worse than ex­pect­ed – in­creas­ing­ly se­quen­tial­ly…Def­i­nite­ly more dis­con­cert­ing, how­ev­er, was the rev­e­la­tion that at cer­tain pe­ri­ods dur­ing the quar­ter, the com­pa­ny’s “high­er than av­er­age va­can­cy rate in (their) sales force” with 18 of 80, or 22% of sales ter­ri­to­ries ‘not hav­ing a sales rep at some point in the quar­ter.’ While seats have ap­par­ent­ly been most­ly re-filled…this sce­nario rais­es con­cerns re­gard­ing the sus­tain­abil­i­ty of the ap­par­ent re­bound seen in April (2Q to date). How­ev­er, the sub­dued tone with which com­men­tary was de­liv­ered, makes it chal­leng­ing to muster con­fi­dence that com­mer­cial dy­nam­ics can achieve even low­ered full-year 2019 Ner­l­ynx sales guid­ance,” Cowen an­a­lysts wrote in a note.

SVB Leerink an­a­lysts low­ered their 2019 US rev­enue es­ti­mates to $221 mil­lion from $265 mil­lion and tem­pered their peak US sales ex­pec­ta­tions to about $369 mil­lion from $400 mil­lion.

Af­ter suc­cess­ful­ly lob­by­ing Eu­ro­pean reg­u­la­tors to have a change of heart and ap­prove Ner­l­ynx last year, Puma palmed off the treat­ment to Pierre Fab­re — its sixth mar­ket­ing part­ner —with the Unit­ed States and Japan as the on­ly re­main­ing un­en­cum­bered ma­jor mar­kets.

Mov­ing Out of the Clin­ic with Dig­i­tal Tools: Mo­bile Spirom­e­try Dur­ing COVID-19 & Be­yond

An important technology in assessing lung function, spirometry offers crucial data for the diagnosis and monitoring of pulmonary system diseases, as well as the ongoing measurement of treatment efficacy. But trends in the healthcare industry and new challenges introduced by the COVID-19 pandemic are causing professionals in clinical practice and research to reevaluate spirometry’s deployment methods and best practices.

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Sanofi, Glax­o­SmithK­line jump back in­to the PhI­II race for a Covid vac­cine — as the win­ners con­gre­gate be­hind the fin­ish line

Sanofi got out early in the race to develop a vaccine using more of a traditional approach, then derailed late last year as their candidate failed to work in older people. Now, after likely missing the bus for the bulk of the world’s affluent nations, they’re back from that embarrassing collapse with a second attempt using GSK’s adjuvant that may get them back on track — with a potential Q4 launch that the rest of the world will be paying close attention to.

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SCO­TUS de­clines to re­view En­brel biosim­i­lar case, tee­ing up 30+ years of ex­clu­siv­i­ty and $20B more for Am­gen’s block­buster

As the House Oversight Committee is set to grill AbbVie CEO Richard Gonzalez on Tuesday over tactics to block competition for its best-selling drug of all time, another decision on Capitol Hill on Monday opened the door for billions more in Amgen profits over the next eight years.

The Supreme Court on Monday denied Novartis subsidiary Sandoz’s petition to review a Federal Circuit’s July 2020 decision concerning its biosimilar Erelzi (etanercept-szzs), which FDA approved in 2016 as a biosimilar to Amgen’s Enbrel (etanercept). Samsung’s Enbrel biosimilar Eticovo also won approval in 2019 and remains sidelined.

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No­var­tis' En­tresto takes its 2nd fail­ure of the week­end at ACC, show­ing no ben­e­fit in most dire heart fail­ure pa­tients

Novartis’ Entresto started the ACC weekend off rough with a trial flop in heart attack patients, slowing the drug’s push into earlier patients. Now, an NIH-sponsored study is casting doubt on Entresto’s use in the most severe heart failure patients, another black mark on the increasingly controversial drug’s record.

Entresto, a combination of sacubitril and valsartan, could not beat out valsartan alone in an outcomes head-to-head for severe heart failure patients with a reduced ejection fraction (HFrEF), according to data presented Monday at the virtual American College of Cardiology meeting.

How to man­u­fac­ture Covid-19 vac­cines with­out the help of J&J, Pfiz­er or Mod­er­na? Bi­ol­yse sees the dif­fi­cul­ties up close

When Biolyse, an Ontario-based manufacturer of sterile injectables, forged a deal with Bolivia last week to manufacture up to 50 million J&J Covid-19 vaccine doses, the agreement kicked off what will prove to be a test case for how difficult the system of compulsory licenses is to navigate.

The first problem: When Biolyse asked J&J, via a March letter, to license its Covid-19 vaccine, manufacture it in Canada and pay 5% royalties on shipments to needy, low-income countries, J&J rejected the offer, refusing to negotiate. J&J also did not respond to a request for comment.

Tim Mayleben (L) and Sheldon Koenig (Esperion)

On the heels of a sting­ing Q1 set­back, Es­pe­ri­on's long­time cham­pi­on is ex­it­ing the helm and turn­ing the wheel over to a mar­ket­ing pro

Just days after getting stung by criticism from a badly disappointed group of analysts, there’s a big change happening today at the helm of Esperion $ESPR.

Longtime CEO Tim Mayleben, who championed the company for 9 years from early clinical through a lengthy late-stage drive to successfully get their cholesterol drug approved for a significant niche of patients in the US, is out of the C suite, effective immediately. Sheldon Koenig — hired at the end of 2020 with a resume replete with Big Pharma CV sales experience —  is stepping into his place, promising to right a badly listing commercial ship that’s been battered by market forces.

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Matt Gline (L) and Vivek Ramaswamy

In­sid­er ac­count of Roivan­t's SPAC deal — and that $7.3B val­u­a­tion — re­veals a few se­crets as Matt Gline po­si­tions the com­pa­ny as the new ‘Big Phar­ma’

It was Oct. 7, 2020, and Matt Gline wasn’t wasting any time.

The CEO of Roivant had word that KKR vet Jim Momtazee’s SPAC had priced late the night before, triggering a green light for anyone interested in pursuing a big check for future operations and riding the financial instrument to Nasdaq. So he wrote a quick email congratulating Momtazee, whom he knew, for the launch.

Oh, and maybe Momtazee would like to schedule something with Gline and his executive chairman, Roivant founder Vivek Ramaswamy, to chat about Roivant and its business?

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Re­gen­eron's Evkeeza shows promise in curb­ing high triglyc­erides, but will ge­net­ic dis­par­i­ties lim­it use?

When Regeneron scored an early approval for lipid lowering antibody Evkeeza back in February, the drugmaker cracked open a new pathway to lower abnormally high cholesterol levels. Now, Regeneron is chasing high triglycerides as well with some promising mid-stage data — but will genetic restrictions limit the drug’s use?

Regeneron’s Evkeeza (evinacumab) cut median triglyceride levels by more than 800 mg/dL (57%) in patients with a rare disorder causing abnormally high triglyceride levels compared with an overall increase of 50 mg/dL (1.8%) in participants on placebo, according to Phase II data presented Sunday at the virtual American College of Cardiology meeting.

$DNA is once again on NYSE; FDA clears Soliris chal­lenger for the mar­ket; Flag­ship’s think­ing big again with eR­NA; and more

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I still remember the uncertainty in the air last year when nobody was sure whether ASCO would cancel their in-person meeting. But it’s now back again for the second virtual conference, and Endpoints News is here for it. Check out our 2-day event reviewing the landscape of cancer R&D and send news our way.

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