Wednesday, February 7, 2018

The Readout by Damian Garde & Meghana Keshavan

Welcome to The Readout, where we keep you on top of the latest in biotech. For more in-depth coverage of biopharma, subscribe to STAT Plus. On Twitter: @damiangarde@megkesh, and @statnews.

Gilead rips off the hepatitis C Band-Aid


Grand opening, grand closing (Brad Loncar)

Here’s an eye-popping way to think about Gilead Sciences’ rapidly disappearing hepatitis C business. This year, the company expects sales of its hepatitis C drugs to fall by nearly 60 percent to a range of $3.5 billion to $4 billion. In 2015, Gilead was reporting hepatitis C sales nearing $5 billion every quarter. 

If you’re thinking all this spells doom for Gilead, you’re not applying the counter-intuitive logic of Wall Street. Bad revenue guidance is okay when investors already expect it. Really awful revenue guidance — like what Gilead dished up last night — is bullish because sales can’t fall any further. The floor has been reached. And when you’re on the floor, there is only one direction to go. Up! Growth!

Got that? Welcome to Wall Street.

David Mitchell's big plan to sway the midterms

The cancer patient who last year founded the advocacy group Patients for Affordable Drugs, last week unveiled the next big step in his push to take on high drug prices: a new political action arm.

David Mitchell's new organization, called Patients for Affordable Drugs NOW, has big plans and a seven-figure budget for November's midterms to try to boost politicians deemed friendly to lower drug prices, and sink those perceived as likely to keep prices high.

One story to watch: How Mitchell's group will respond to a possible run for the Senate by Bob Hugin, the newly retired Celgene chairman and drug price hiker who's weighing whether to get into the race in his home state of New Jersey.

Read more about what Mitchell has in the works.

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Now we have some migraine data

While the effort to develop injections for chronic migraines has gained attention, there's also been a simmering contest to develop a pill that would deal with the acute form of severe headache. And in that race, we now have a benchmark.

Allergan reported the first of two late-stage studies on its migraine pill, disclosing that 21.2 percent of patients who got the drug were pain-free two hours after dosing. That beat placebo by enough to qualify as a success, but it was worse than the 25.5 percent Allergan saw in Phase 2.

This all sets the stage for data from BioHaven, expected this quarter, on a pill that works exactly the same way. In a prior Phase 2 study, 31.4 percent of patients taking BioHaven's drug had no pain after two hours — and it didn't have the liver toxicity issues that have dogged Allergan's program.

Fired biotech CEO: Actually you can't fire me

A weird thing that happened last week was Arcturus Therapeutics' unexplained firing of its CEO, Joseph Payne. A thing that happened last night was an SEC filing from Payne in which he "disputes the legal efficacy of such termination under applicable law."

According to Payne's attorneys, the move to fire him began at a board meeting in January, in which four members tried to pass a resolution to force him out and "had our client physically removed from the building." That's a breach of company bylaws, Payne's attorneys say, and thus he should technically still be CEO.

In a statement issued after 11 p.m. ET, Arcturus said its board "believes that Mr. Payne has demonstrated that he is unable to put the needs of the company and its shareholders ahead of his own self-interest," and that he was fired for conduct "deemed to be contrary to the best interests of the company and its shareholders."

Express Scripts goes right ahead and makes PhRMA's point

Customers of Express Scripts, the nation's largest PBM, saw their drug spending go up by just 1.5 percent last year, which is the smallest increase the company has seen since it started keeping tabs 25 years ago.

Express Scripts billed it as a validation of its labors — "Our clinical programs assure patients get the right drug, and then make sure they get it at the right price," CEO Tim Wentworth said — but is it not also exactly what the drug industry has been saying?

PhRMA has long pointed out that drug spending is among the smallest and slowest-growing facets of U.S. health care expenditures, and the industry's latest tack is that drugs that work actually save the system money by reducing hospitalizations and forestalling surgeries.

So everyone agrees and we can all stop fighting, yes?

More reads

  • Omeros cataract surgery drug faces steep sales declines with expiration of favorable Medicare reimbursement. (STAT Plus)
  • In diabetes war, Novo Nordisk aims to break mold with new pill. (Reuters)
  • Bristol-Myers Squibb sows confusion. (In the Pipeline)
  • The diseases we aren't curing — and why. (Fortune)

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