Nov. 25, 2014, 8:18 AM
- Pharmacy benefits manager Express Scripts (NASDAQ:ESRX) is at the forefront of an increasing wave of resistance to the high prices of new drugs from pharma and biotech firms, some which cost as much as $50K per month. Pharmaceutical spending in the U.S. is $270B and may breach $500B in five years. ESRX's method of controlling costs is to refuse to pay for them. For 2015, for example, it is excluding 66 branded drugs from its main formulary, an increase of 18 from 2014's 48. On the list is Johnson & Johnson's (NYSE:JNJ) rheumatoid arthritis drug Simponi (golimumab) which costs $3K per month.
- Other prescription benefits managers are employing similar tactics. CVS Health (NYSE:CVS) will exclude 95 drugs from its 2015 formulary including Pfizer's (NYSE:PFE) multiple sclerosis med Rebif (interferon beta-1a) which costs $5K for a four-week supply.
- Governments are pushing back as well. Among 42 state Medicaid programs, 27 pay for Gilead Sciences' HCV med Sovaldi (sofosbuvir) only for patients with severe liver damage while others impose coverage limitations for patients with recent substance-abuse problems. In the U.S., the full regimen cost is $84K. Recently, Britain's National Institute for Health and Care Excellence (NICE) balked at recommending reimbursement for Roche's (OTCQX:RHHBY) blood cancer drug Gazyvaro (obinutuzumab).
- Ninety percent of commercial health plans require pre-approval of specialty drugs, up from 82% in 2011.
- Previously: Roche's Gazyvaro not NICE in the UK
- Previously: Global drug tab will breach trillion dollar mark this year
- ETFs: IBB, BIB, IRY, BIS, IXJ, DRGS
- Related tickers: (NYSE:NVS) (NYSE:AZN) (NASDAQ:AMGN) (NASDAQ:BIIB) (NASDAQ:CELG) (NYSE:LLY) (NYSE:SNY) (NYSE:ABT) (NYSE:ABBV) (NYSE:BMY) (NYSE:MRK) (NYSE:GSK)
Nov. 24, 2014, 8:40 AM
- Tetraphase Pharmaceuticals (NASDAQ:TTPH) is reportedly considering selling itself after being approached by interested suitors. Sources say the acquirer could be Acetelion (OTCPK:ALIOF) (OTC:ALIOY) or Roche (OTCQX:RHHBY).
- The attraction is Tetraphase's antibiotic eravacycline, currently in Phase 3 development. Both oral and IV formulations of the drug have demonstrated higher dose response rates than Johnson & Johnson's (NYSE:JNJ) Levaquin (levofloxacin) for the treatment of complicated urinary tract infections. In the Ignite-2 study, patients receiving 200 mg eravacycline IV-to-oral doses achieved a response rate of 70.8% while patients receiving 250 mg IV-to-oral doses achieved 64.3%, both significantly ahead of Levaquin's 52.2% response rate.
- A trial comparing eravacycline to Merck's (NYSE:MRK) Invanz (ertapenem) for the treatment of complicated intra-abdominal infections is underway.
- TTPH is up 18% premarket on light volume.
- Previously: Tetraphase completes eravacycline Phase 3 enrollment
Nov. 24, 2014, 8:02 AM
- The European Commission approves AstraZeneca's (NYSE:AZN) Duaklir Genuair (aclidium bromide/formoterol fumarate 340/12 mcg) for the maintenance bronchodilator treatment in adults with chronic obstructive pulmonary disease (COPD).
- The product is a fixed dose combination of two approved long-acting bronchodilators with different mechanisms of action. Aclidium bromide is an anticholinergic or long-acting muscarinic antagonist that produces bronchodilation by inhibiting the muscarinic M3 receptor in the airway smooth muscle. Formoterol fumarate is a long-acting beta-agonist that stimulates the B2-receptors in the bronchial smooth muscle resulting in bronchodilation. Both are currently approved as stand-alone therapies for the maintenance treatment of COPD in the U.S. and Europe.
- Genuair is a multi-dose pre-loaded dry powder inhaler that utilizes optical and acoustic signals to inform the patient that the correct dose has been delivered.
- COPD-related tickers: (NYSE:GSK) (NYSE:NVS) (NASDAQ:THRX) (NASDAQ:REGN) (NYSE:SNY) (NYSE:TEVA) (OTCQX:RHHBY)
Nov. 23, 2014, 3:21 PM
- Group says Genentech's (OTCQX:RHHBY) change to distribution of oncology drugs will negatively impact U.S. hospitals, clinics, and their patients.
- Says that while the distribution shift may improve Genentech's model, "it does so at the expend of the efficiencies, quality and safety within U.S. hospitals and clinics."
- Asks that Genentech "reverse this ill-advised decision."
- Source: Gautam Kollu
Nov. 20, 2014, 7:41 AM
- According to IMS Health (NYSE:IMS) global drug spending will top $1T this year led by Gilead's (NASDAQ:GILD) Sovaldi (sofosbuvir) for hep C and new cancer drugs. The projected spend of $1.06T represents a 7% increase from last year.
- By 2018, drug spending is projected to rise to $1.3T. Hepatitis C and cancer meds will add ~$100B each, while diabetes care will contribute $78B. Leading the charge in cancer will be Roche's (OTCQX:RHHBY) Perjeta (pertuzumab) and Kadcyla (ado-trastuzumab emtansine), Pharmacyclics' (NASDAQ:PCYC) Imbruvica (ibrutinib) and Amgen's (NASDAQ:AMGN) Kyprolis (carfilzomib).
- The ever-increasing tab for meds will be controversial because payers' budgets are being stressed while drug developers defend their prices citing high development costs.
- There is already some push back in cancer. Britain's National Institute for Health and Care Excellence (NICE), which sets guidelines for the National Health Service on costs, procedures and technologies, is balking at approving Roche's Gazyvaro (obinutuzumab) and Kadcyla citing their high cost relative to additional benefits over existing therapies.
- Previously: Roche's Gazyvaro not NICE in the UK
- ETFs: IBB, BIB, IRY, BIS, IXJ, DRGS
Nov. 17, 2014, 9:07 AM| Comment!
Nov. 17, 2014, 8:57 AM
- Celldex Therapeutics (NASDAQ:CLDX) is up 20% premarket on robust volume in response to its announcement of interim data from is Phase 2 clinical trial assessing the safety and efficacy of rindopepimut in patients with EGFRvIII-positive glioblastoma (GBM). The results demonstrate signs of clinical activity including groups both naive and refractory to Avastin (bevacizumab) (OTCQX:RHHBY).
- Rindopepimut (Rintega) is an investigational immunotherapy that targets the tumor-specific oncogene EGFRvIII. Patients in this category have a worse prognosis that the overall glioblastoma population and poor long term survival prospects.
- In the bevacizumab-naive group, the primary endpoint is progression-free survival at six months (PFS-6). The value for the rindopepimut arm is 27% compared to 11% in the control arm (p=0.048). Statistically significant overall survival (OS) benefit: rindopepimut median: 12.0 months versus control median of 8.8 months (p=0.0208). Hazard ratio: 0.47.
- In the bevacizumab-refractory group, rare but prominent anti-tumor activity did not meet the hurdle for expanded accrual. Noteworthy OS compared to historical values. Rindopepimut plus bevacizumab was well-tolerated, no serious adverse events attributed to rindopepimut. Early anti-EGFRvIII immune response correlates with survival benefit.
Nov. 14, 2014, 2:00 PM
- The FDA approves a label expansion for Genentech's (OTCQX:RHHBY) Avastin (bevacizumab). The new indication is, in combination with chemotherapy, for the treatment of women with platinum-resistant, recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer who have received no more than two prior chemotherapy regimens.
- Avastin is also approved in the U.S. as part of a combination therapy for colon, lung, kidney and cervical cancer.
Nov. 13, 2014, 5:02 PM
- In a 479-patient Phase 2 clinical trial, Puma Biotechnology's (NYSE:PBYI) tyrosine kinase inhibitor, PB272 (neratinib), with paclitaxel demonstrated comparable results to Roche's (OTCQX:RHHBY) Herceptin (trastuzumab) plus paclitaxel as a first-line treatment in patients with HER2-positive locally recurrent or metastatic breast cancer.
- The primary endpoint was progression-free survival (PFS). Secondary endpoints included objective response rate (ORR) and the incidence of central nervous system (CNS) metastases, including metastases of the brain.
- PFS and ORR for the neratinib/paclitaxel arm were 16.6 months and 74.8%, respectively versus 16.7 months and 75.1%, respectively for the trastuzumab/paclitaxel arm. The differences were not statistically significant.
- There was a 52.6% reduction in CNS metastases in the neratinib/paclitaxel group compared to the trastuzumab/paclitaxel group (7.4% vs. 15.6%) (p=0.006). The difference was statistically significant.
- The safety results showed a 30% incidence of grade 3 diarrhea in the neratinib/paclitaxel arm compared to 4% in the trastuzumab/paclitaxel arm. When high dose loperamide was administered in another trial, though, the incidence of grade 3 diarrhea dropped to 8% in patients receiving neratinib as monotherapy.
- The results of the study will be presented at a future scientific meeting.
- PBYI is down 7.9% after hours on average volume.
Nov. 11, 2014, 7:44 AM
- Dupilumab, a fully-human monoclonal antibody being co-developed by Sanofi (NYSE:SNY) (OTCQB:SNYNF) and Regeneron Pharmaceuticals (NASDAQ:REGN), showed showed positive results in a 776-patient Phase 2b dose-ranging clinical trial in adults with moderate-to-severe uncontrolled asthma.
- The three highest doses of dupilumab in combination with standard-of-care therapy met the primary endpoint of a statistically significant improvement from baseline in forced expiratory volume over one second (FEV1) at week 12 in patients with high blood eosinophils (>= 300 cells/microliter) compared to placebo in combination with standard-of-care therapy. Also, two doses of dupilumab (200 mg every other week and 300 mg every other week) showed a statistically significant improvement in mean percent change in FEV1 and a reduction in severe exacerbations, both in the high eosinophils group and the overall study population.
- Dupilumab blocks IL-4 and IL-13, two cytokines required by the Th2 immune response. Some researchers believed that targeting the Th2 pathway would limit the benefit in asthmatics with high eosinophils, but this study demonstrated that it could be effective. Final results from the trial will be presented at a future medical conference.
- Sanofi plans to proceed to Phase 3 development.
- Asthma-related tickers: (NYSE:GSK) (NYSE:TEVA) (NYSE:AZN) (OTCQX:RHHBY) (NASDAQ:AMGN) (NYSE:MRK) (NYSE:NVS) (NASDAQ:THRX)
Nov. 10, 2014, 12:31 PM
- At the Biennial Meeting of the International Gynecologic Cancer Society in Melbourne, Australia, investigators presented Phase 2 data for OxiGene's (OXGN -7.4%) fosbretabulin combined with Roche's (OTCQX:RHHBY +0.5%) Avastin (bevacizumab) for the treatment of recurrent ovarian, tubal and peritoneal carcinoma.
- The study achieved its primary endpoint of a statistically significant increase in progression-free survival (PFS) for the combination compared to bevacizumab alone (p=0.049). Mean PFS for the combo was 7.3 months (n=54) versus 4.8 months for bevacizumab (n=53).
- In a post hoc subgroup analysis, there was also a statistically significant improvement in PFS in patients who were platinum-resistant (n=27). Median PFS for the combo group was 6.7 months compared to 3.4 months for bevacizumab alone (p=0.01).
- Patients receiving the combo also showed a higher objective response rate (ORR) but the results were not statistically significant.
Nov. 6, 2014, 8:03 AM
- In a setback for India's generic drug firm Ranbaxy Laboratories Ltd., the FDA revokes its previously granted tentative approvals for its lower cost versions of AstraZeneca's (NYSE:AZN) heartburn med Nexium and Roche's (OTCQX:RHHBY) antiviral Valcyte.
- The agency informed the company that while there were no data integrity issues related to its filings, its decisions granting the approvals were "in error."
- The revocation also terminates its six-month first-to-file market exclusivity.
- Management says in a statement, "Ranbaxy is disappointed with this development and is actively evaluating all available options to preserve its rights."
Nov. 5, 2014, 7:34 AM| Comment!
Nov. 3, 2014, 1:06 PM
- The FDA accepts Boehringer Ingelheim's NDA for Spiriva Respimat (tiotropium bromide) for the maintenance treatment of asthma in patients at least 12 years old who remain symptomatic on at least inhaled corticosteroids.
- Spiriva is currently cleared for the maintenance treatment of bronchospasm (HandiHaler) associated with chronic obstructive pulmonary disease (COPD) and to reduce COPD exacerbations.
- The Respimat inhaler provides a pre-measured amount of medicine in a slow moving mist that helps the patient inhale the drug. It is designed to deliver the medication in a way that does not depend on how fast air is breathed in from the inhaler.
- Asthma and COPD-related tickers: (THRX -3%)(GSK -0.3%)(AZN -0.8%)(NVS -1.3%)(REGN +0.6%)(SNY -1.5%)(TEVA +1.5%)(OTCQX:RHHBY -1.3%)
Oct. 28, 2014, 12:44 PM
- Roche's (OTCQX:RHHBY +0.5%) Ventana Medical Systems enters into an agreement with ImmunoGen (IMGN +2.2%) to develop biomarker assays and a companion immunohistochemistry diagnostic test for one or more of ImmunoGen's product candidates. The initial test in the partnership is for folate receptor alpha (FRa) that is being used in the trials of ImmunoGen's FRa-targeting antibody-drug conjugate, IMGN853. Certain cancers such as epithelial ovarian and endometrial, highly express FRa.
- Specific financial terms are not disclosed.
Oct. 20, 2014, 10:40 AM
- Laboratory Corporation of America (LH -0.2%) launches its HIV GenoSure Archive, the first laboratory test that helps clinicians optimize antiretroviral (ARV) drug regimens for virally suppressed HIV patients. The test was developed using the Next Generation Sequencing Platform (NGS).
- Previous lab testing to guide ARV drug selection required higher viral loads than many HIV patients have. GenoSure Archive is performed by amplifying cell-associated HIV-1 DNA from infected cells in whole blood samples and then analyzing the polymerase region using NGS methods. The assay is analytically validated to identify mutations associated with resistance to all members of the most widely used ARV drug classes.
- HIV-related tickers: (ABBV +1.2%)(GILD +1.6%)(BMY +0.1%)(PFE -0.2%)(GSK -0.3%)(ABT +0.2%)(JNJ +0.1%)(PGNX +3%)(MRK +0.1%)(OTCQX:RHHBY +0.6%)
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