Sanofi/Re­gen­eron’s one-two punch on PC­SK9 price and health da­ta wins a key con­vert as Ex­press Scripts cre­ates ex­clu­sive for­mu­la­ry deal

Just 7 weeks af­ter Sanofi $SNY and Re­gen­eron $REGN flagged piv­otal da­ta on a clear mor­tal­i­ty ben­e­fit to be had from its PC­SK9 car­dio drug Pralu­ent, they’re back with a chum­my pub­lic self­ie with Ex­press Scripts that swaps a new dis­count price in ex­change for a pledge to dis­man­tle any hur­dles that could pre­vent the PBM’s 20 mil­lion mem­bers from tak­ing ad­van­tage of it.

Len Schleifer

No­body’s talk­ing specifics here, but in March Sanofi/Re­gen­eron pledged to cut its price to $4,460 to $7,975 a year for pay­ers who are will­ing to stop throw­ing up road­blocks to this drug, drop­ping to a price that on the low end is not much high­er than the $10-a-day cost of the old gen­er­a­tion of statins be­fore they went gener­ic. At the high end, it still marks a sharp drop from the $14,000 whole­sale price that had been the mar­ket stan­dard used to peg dis­counts against.

Salt­ing that deal with new mor­tal­i­ty ben­e­fits from longterm use, a goal that elud­ed ri­val Am­gen, ap­pears to be enough for at least one of the most promi­nent phar­ma­cy play­ers to see their way through to drop­ping the com­plex ap­proval process that made this drug a non­event on the bot­tom line. Ex­press Scripts is giv­ing Sanofi/Re­gen­eron an ex­clu­sive place on their for­mu­la­ry — take that, Am­gen — with a pledge to pass along the sav­ings to its mem­bers through low­er out-of-pock­et ex­pens­es.

The blunt Re­gen­eron CEO Len Schleifer said the deal was “de­signed to break the grid­lock so that Pralu­ent is fi­nal­ly able to reach pa­tients most in need. U.S. car­di­ol­o­gists have ex­pe­ri­enced un­prece­dent­ed chal­lenges in se­cur­ing ac­cess for Pralu­ent for pa­tients who were clear­ly ap­pro­pri­ate, but were de­nied cov­er­age. This agree­ment sets a new stan­dard in in­dus­try and pay­er col­lab­o­ra­tion that we hope will serve as a mod­el for how to make in­no­v­a­tive med­i­cines more ac­ces­si­ble and af­ford­able.” 

And ICER chief Steven Pear­son of­fered his en­dorse­ment, hap­py to see some re­al ne­go­ti­at­ing on price and ac­cess. He not­ed:

Fol­low­ing a decades-long trend to­ward dys­func­tion and fin­ger-point­ing, the US health care sys­tem is be­gin­ning to ad­dress its drug pric­ing prob­lem through the emer­gence of a ‘grand bar­gain.’ When a man­u­fac­tur­er is will­ing to re­spon­si­bly price an in­no­v­a­tive med­i­cine in line with its clin­i­cal ben­e­fits, pay­ers should rec­i­p­ro­cate by re­mov­ing the hur­dles that can pre­vent pa­tients from get­ting the drug.

Mike Suesser­man

Sanofi/Re­gen­eron and Am­gen have been duk­ing it out over who owns the patents on PC­SK9, but both have been es­sen­tial­ly side­lined by pay­ers’ per­sis­tent re­fusal to hit a green light on these drugs. With physi­cians star­ing at a pile of pa­per­work and re­peat­ed de­nials, these com­pa­nies nev­er had a chance at the orig­i­nal high price they want­ed to fetch. Re­al­i­ty dawned slow­ly, but the sun is com­ing up on a field that a host of an­a­lysts still res­olute­ly be­lieves is a block­buster mar­ket in the mak­ing.

“We’ve been out on the mar­ket close to three years,” says Mike Suesser­man, VP of the car­diometa­bol­ic and opthamol­o­gy busi­ness unit at Re­gen­eron. They’ve seen lots of feed­back along the way and iden­ti­fied what the crit­i­cal hur­dles are. This deal, he says, ad­dress­es those hur­dles.

“In that sense I think it’s a huge leap for­ward.”

You can bet that more such leaps for­ward are in the works as Am­gen looks to strike back on the phar­ma­cy front.

Part club, part guide, part land­lord: Arie Bellde­grun is blue­print­ing a string of be­spoke biotech com­plex­es in glob­al boom­towns — start­ing with Boston

The biotech industry is getting a landlord, unlike anything it’s ever known before.

Inspired by his recent experiences scrounging for space in Boston and the Bay Area, master biotech builder, investor, and global dealmaker Arie Belldegrun has organized a new venture to build a new, 250,000 square foot biopharma building in Boston’s Seaport district — home to Vertex and a number of up-and-coming biotech players.

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Novotech CRO Ex­pands Chi­na Team as Biotech De­mand for Clin­i­cal Tri­als In­creas­es up to 79%

An increase in demand of up to 79% for clinical trials in China has prompted Novotech the Asia-Pacific CRO to rapidly expand the China team, appointing expert local clinical executives to their Shanghai and Hong Kong offices. The company is planning to expand their team by 30% over the next quarter.

Novotech China has seen considerable demand recently which is borne out by research from GlobalData:
A global migration of clinical research is occurring from high-income countries to low and middle-income countries with emerging economies. Over the period 2017 to 2018, for example, the number of clinical trial sites opened by biotech companies in Asia-Pacific increased by 35% compared to 8% in the rest of the world, with growth as high as 79% in China.
Novotech CEO Dr John Moller said China offers the largest population in the world, rapid economic growth, and an increasing willingness by government to invest in research and development.
Novotech’s 23 years of experience working in the region means we are the ideal CRO partner for USA biotechs wanting to tap the research expertise and opportunities that China offers.
There are over 22,000 active investigators in Greater China, with about 5,000 investigators with experience on at least 3 studies (source GlobalData).

UP­DAT­ED: With loom­ing ‘apoc­a­lypse of drug re­sis­tance,’ Mer­ck’s com­bi­na­tion an­tibi­ot­ic scores FDA ap­proval on two fronts

Merck — one of the last large biopharmaceuticals companies in the beleaguered field of antibiotic drug development — on Wednesday said the FDA had sanctioned the approval of its combination antibacterial for the treatment of complicated urinary tract and intra-abdominal infections.

To curb the rise of drug-resistant bacteria and maintain the efficacy of the therapy, Recarbrio (and other antibacterials) — the drug must be used to treat or prevent infections that are proven or strongly suspected to be caused by susceptible gram-negative bacteria, Merck $MRK said.

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John McHutchison in 2012. Getty Images

The $1.1M good­bye: Gilead CSO John McHutchi­son is out as Daniel O’Day shakes up the se­nior team

Just a little more than a year after John McHutchison grabbed a promotion to become CSO at Gilead in the wake of Norbert Bischofberger’s exit, he’s out amid a shakeup of the senior team that is also triggering the departure of two other top execs.

Gilead stated that McHutchison “has decided to step down” from the job as of August 2nd. And their SEC filing notes that he’ll be getting a $1.1 million check to settle up on his contract.

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Thomas Gajewski, David Steinberg. (CRI, Pyxis)

Bay­er, Long­wood back star re­searcher's deep dive in­to the tu­mor mi­croen­vi­ron­ment for new I/O tar­gets

From PD-1 targeting to the RAS pathway to the STING complex, Thomas Gajewski has spent the past two decades of his career decoding the various ways the immune system can be unleashed to defend against cancer. So when the University of Chicago professor comes around to putting all his findings into a new platform for finding new targets, VCs and pharma groups alike pay attention.

“He’s been studying T cells for 20 years, plus he’s one of the world’s leaders if not the world leader in the space,” David Steinberg, partner at Longwood Fund, said. “Furthermore, let me add he did a lot of the foundational research and also some of the seminal clinical trials in the existing set of I/O agents. He understands the space really well, he understands the current strengths, and I think he understood really well what was missing, so he knew where to look.”

Kamala Harris speaking yesterday at the Des Moines Register Iowa Presidential Candidate Forum [via Getty]

Who’s the tough­est on drug prices? A game of po­lit­i­cal one-up­man­ship is dri­ving the pol­i­cy de­bate in Wash­ing­ton

Earlier this week we got a look at Senator Kamala Harris’ position on drug prices. She’s proposing that HHS take an average price from single-payer systems like the UK, Germany and Canada — which leverage market access for lower prices — and use that to set the US price. Anything drug companies collect above that would be taxed at a rate of 100%.

And the rhetoric is scathing:
While families struggle to make it to the end of the month, pharmaceutical companies are turning record profits. They’re spending nearly as much on advertising as R&D. They’re manipulating their market power to hike prices on lifesaving generic drugs. They’re making twice the profit of the average industry in America and still increased drug prices by 10.5% over the past six months alone. Meanwhile, they are charging dramatically higher prices to American consumers.
That’s an escalation on Joe Biden’s plan, which includes drug importation from those cheaper markets as well as allowing Medicare to negotiate prices — something that virtually all Dems agree on now.

H1 analy­sis: The high-stakes ta­ble in the biotech deals casi­no is pay­ing out some record-set­ting win­nings

For years the big trend among dealmakers at the major players has been centered on ratcheting down upfront payments in favor of bigger milestones. Better known as biobucks for some. But with the top 15 companies competing for the kind of “transformative” pacts that can whip up some excitement on Wall Street, with some big biotechs like Regeneron now weighing in as well, cash is king at the high stakes table.

We asked Chris Dokomajilar, the head of DealForma, to crunch the numbers for us, looking over the top 20 deals for the past decade and breaking it all down into the top alliances already created in 2019. Gilead has clearly tipped the scales in terms of the coin of the bio-realm, with its record-setting $5 billion upfront to tie up to Galapagos’ entire pipeline.

Dokomajilar notes:

We’re going to need a ‘three comma club’ for the deals with over $1 billion in total upfront cash and equity. The $100 million-plus club is getting crowded at 164 deals in the last decade with new deals being added towards the top of the chart. 2019 already has 14 deals with at least $100 million in upfront cash and equity for a total year-to-date of over $9 billion. That beats last year’s $8 billion and sets a record.

Add upfronts and equity payments and you get $11.5 billion for the year, just shy of last year’s record-setting $11.8 billion.

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Takeda's trans­la­tion­al cell ther­a­py group revs up for a race to the clin­ic with off-the-shelf CAR-T

Four years after Takeda launched a wide-ranging induced pluripotent stem cell project with the researchers at Nobel prize-winning Shinya Yamanaka’s lab at the University of Kyoto, the pharma company is taking delivery of the first of what it hopes will be a whole pipeline of iPS cell-derived therapies that can deliver on the promise of off-the-shelf CAR-T therapies.

From here, Stefan Wildt — the head of pharma sciences and translational cell therapy at Takeda — and his group of 100-plus scientists will be charged with steering their way to the clinic as they build out the manufacturing and support work for this pipeline-in-the-making. 

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SJ Lee [File photo]

Go­ing in­side cells, Sung Joo Lee has sketched some big goals for his small — but glob­al — team of drug hunters

For a small biotech based in South Korea with a research arm in Cambridge, MA, Orum Therapeutics has sketched out some big goals aimed at developing antibodies for intracellular targets. And now they have a new $30 million round to push the work forward, aiming at a slate of currently undruggable quests.

Orum has been working on a platform tech out of Ajou University that relies on endocytosis to smuggle antibodies and their cargo inside a cell. They’ve published work in Nature that illustrates its preclinical potential in RAS mutations, and KRAS is on their list of targets. 

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