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Andrew Pannu

Andrew Pannu

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How is pharma replacing upcoming LOEs (loss of exclusivity)?

The scale of that problem has never been higher, with >$200B of sales at-risk through 2028

After analyzing the pipelines, management commentary and BD maneuvers of key pharma players, here are some thoughts on how this plays out:

Exhibit 1: Summary of strategy by company

The exposure level of each pharma varies significantly - Merck, Pfizer and BMS are the most exposed, largely driven by their successful oncology & hematology franchises (i.e. Keytruda, Eliquis, etc.). AbbVie has successfully combatted Humira biosimilars via attractive rebates they can offer PBMs.

Exhibit 2: Notable US LOEs through 2028

Half of the >$200B of at-risk revenue is in '27-28, which means now is the time pharma will start angling to replace these via high-conviction R&D & BD efforts

Replacing such a big hole will require big swings. Keep in mind that whatever pharma needs to replace in LOEs is in addition to the standard growth they need to show to justify their valuations.

As we saw with Lilly and Novo's obesity assets this year, projected sales from high-growth novel products will get a premium multiple vs. mature products. Thus, as pharma ages towards big LOEs, their growth mix becomes increasingly unfavorable, and their valuations will compress unless they can point to differentiated new assets that will pick up the slack (& then some).

The larger the peak sales potential of these high-growth assets, the more premium the multiple early on. All of this is why pharma generally doesn't bother with <$1B peak sales products - it doesn't provide enough leverage to move the valuation needle meaningfully (something biotechs looking to be acquired should be conscious of).

Evolving mgmt. commentary shows more willingness for big M&A than just 1-2 years ago. As the biotech bear market continues and 52-week highs are a distant memory, companies that were previously anchored to their pandemic-high valuations have started to reset internally. With that said, early-stage deals will continue to be important, on avg. generating ~60% of core pharma assets

I also looked through the pipelines of these companies to get a sense of what TAs they are focusing on:

Exhibit 3: Pharma clinical pipeline breakdown

Of note, oncology was largely the #1 priority for every company, except Novo. Beyond oncology, immunology & inflammation and cardiovascular/metabolic were the other priorities. This makes sense given the massive TAMs, unmet need and ability to get assets approved across multiple indications.

With the IRA, the ā€œclockā€œ for price negotiation starts at the time of initial launch, so companies are now incentivized to launch in the largest (1st line) setting upfront, as opposed to launching in a late-line setting with a lower bar for success & gradually working upwards. We saw the latter dominant oncology, so it's worth monitoring the impact there on R&D strategy. For now, it doesn’t seem like pharma is shying away.
Post image by Andrew Pannu
Why pharma has stayed away from cell therapy M&A

The dominant strategy has evolved alongside the broader capital markets:

Early on we saw more transformative M&A (Gilead / Kite in 2017, Celgene / Juno in 2018), while 2019-2021 saw an explosion of IPOs as public demand for innovative, earlier-stage companies reached its peak

Frothy valuations for largely early-stage assets & tech put most acquirers on the sidelines

More recently, with the IPO market largely locked up, companies have increasingly relied on private financings, with a select few able to issue follow-ons on the back of excellent clinical or commercial catalysts (i.e. LEGN)

Many mgmt. teams had anchored to their high valuations, despite shifting market dynamics, which created a value dislocation between buyers & sellers

Similar to the broader startup environment, financings today are much more contingent on progress towards meaningful catalysts & asset / platform differentiation - many companies will be unable to raise at favorable terms or at all in this new environment. The long list of cell therapy-focused company layoffs says a lot about the current situation

Even as valuations come down and liquidity tightens, pharma might be unwilling to spend aggressively on acquisitions in this space due to

(1) the pace of innovation: today's cutting-edge approach could be displaced in a few years and
(2) cell therapy's unique supply chain challenges

On the 1st point, the robust funding environment of the past few years has created a crowded landscape pursuing innovations such as:

• Allogeneic therapies
• Overcoming TME
• Controlling cell expansion & persistence
• Increased solid tumor efficacy
• In vivo CAR delivery
• Reduced toxicity & side effect profile
• Alternative cell types

Many would-be acquirers are instead placing multiple bets via BD, particularly around iPSCs, T-Regs, NK cells & other innovative approaches. These deals can actually ā€œencumberā€œ the biotech pipeline as economics are given away, thus limiting the universe of acquirers

The 2nd point speaks to the challenge of scaling up manufacturing while maintaining the viability & functionality of cells. Even years after launch, established players such as BMS and J&J are struggling to keep up with commercial demand - particularly with BCMA CAR-Ts in MM.

Winning requires tons of bespoke investment - cell therapy is not a bolt-on to existing commercial infrastructure and requires unique automation, analytics and supply chain practices

A shortage of experienced & multi-disciplinary talent has complicated moving towards in-house manufacturing. With tighter funding, it's likely companies rely on CDMOs more moving forward, to preserve capital & focus on core competencies.

And even if you reach commercialization, there are concerns as to how effectively cell therapies can penetrate the community setting vs. bsAbs and move towards upfront treatment

Given all that, we'll see how many companies decide to take the leap.
Post image by Andrew Pannu

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