Eiger BioPharmaceuticals (EIGR) announced today results of the Toronto General Hospital ILIAD study in outpatients with mild to moderate COVID-19. Sixty patients were randomized 1:1 to a single subcutaneous dose of Lambda 180 mcg or saline. For those patients with a baseline viral load greater than 6 log copies per milliliter, 15 of 19 patients in the Lambda group were virus negative at Day 7 versus 6 of 16 in the placebo group. This translated to a median time to viral clearance of seven days for Lambda and ten days for placebo.
In the US, there are currently 45,000-50,000 daily new COVID-19 cases diagnosed, up from 30,000 six weeks ago. This can largely be attributed to the opening of schools and restriction relaxation in several states. I had previously forecast daily new infections to decline to 20,000 by late fall, but this now seems optimistic. At 30,000 cases per day, this equates to 900,000 cases per month, or over 3.5 million cases by March. I note that Gilead is charging $3,000 for a five day course of remdesivir, which demonstrated faster recovery times and is focused on moderate to severe COVID-19 patients. More infected people would fall into the ambulatory market, and it is critical to realize that the viral load would not be ascertained for several days after diagnosis. Therefore, the possibility exists for Lambda to be prescribed to this patient group independent of viral load, given its safety profile and subcutaneous administration, although the pricing would have to be appropriate.
I have recently been fortunate to speak with several leading COVID-19 experts, and the predominating opinion is that a vaccine will become widely available in the US in the March-April time frame. The main concern relates to the duration of conferred immunity. In the meantime, they expect new daily cases of around 45,000 in the US (and this number is now 300,000 worldwide). Therefore, this tragic pandemic should result in a sizeable market for therapeutics for at least the next 14 months. Furthermore, COVID-19 is likely to persist for several years as an endemic, unless there is a new, more virulent strain resulting from a mutation.
I have been recommending Eiger's stock for the past year, based on its portfolio of drugs for Hepatitis D, Progeria, post-bariatric hypoglycemia and congenital hyperinsulinism, as I believe these drugs justify a higher stock price. If one considers the contribution of Peginterferon Lambda for COVID-19, even if meaningful for only a few years, the stock's upside is materially higher.
