904 days left


Lots of news out there. Regurgitating it is not useful. Plenty of websites out there for that. Insight? Not much of that around.

AGN whiffing on Naurex assets is not surprising. Long ago real diligence revealed peptide-based NMDA is a really insane way to try this hypothesis. The data were VERY suspect, which is why Naurex went for remarkably little (~$500m if I recall). Speaking of which, Spravato was approved. Must be administered in a physicians office. It appears they underpriced it. If the average price is $750 and I guess patients will use 6 doses per course average, it is very modestly priced for a last-line option in a very severe patient population. Depression patients just don’t go to the office frequently. Getting out of bed is hard enough! In the real world, ketamine is dosed as needed and not on a fixed-schedule. Could break $1 billion if it gains massive adoption, which seems unlikely. J&J is usually very good at launches but flops happen (Invokana, Intelence).

Despite all the advances in CF (like the VX-445 data the other day), CF patients’ lungs are still badly colonized by bacteria. Who will be their white knight in an age where antibiotic development is persona non grata? See Papers I’ve Read section.

For FCSC, KRYS and ABEO, stay cautious. Data quality is really important and companies will put their findings in the best possible light. Be skeptical of single-center data, non-published or non-presented data, etc.

Some big pharma stocks getting tantalizing: GILD, ABBV.

Papers I’ve Read

Once-Daily Plazomicin for Complicated Urinary Tract Infections. Wagenlehner et al. NEJM 2019.
Needed: Antimicrobial Development. Cox, Nambiar, Baden. NEJM 2019.
Plazomicin for Infections Caused by Carbapenem-Resistant Enterobacteriaceae. NEJM 2019.

Plazomicin looks like a new and useful aminoglycoside. An accompanying editorial laments the lack of choices in antibiotics but, alas, the authors are lying. Plazomicin, sold by AKAO, had a whopper of a first quarter, selling around $500,000. I think Britney Spears’ back catalog did better than that. Trashy, my cat, probably earned more in YouTube revenue. If new antibiotics are needed so desperately, why aren’t you doctors who write these editorials actually prescribing them? AKAO is nearly out of business (give it another quarter or two). So, desperately wishing corporate suicide will not get you far. Torching cash is usually not a preferred method of wealth disposal. For drug companies, the only obvious choice to me is to raise the price of antibiotics, especially last-line agents. Serious treatment-resistant infections are lethal–why shouldn’t they have cancer-like pricing if one’s life is on the line?

Sacituzumab Govitecan-hziy in Refractory Metastatic Triple-Negative Breast Cancer. Bardia et al. NEJM 2019.
These data are incredible. Should be the next Ibrance. What am I missing? Doesn’t that make IMMU a 5x?


I introduced some of my fellow inmates to jazz music. Feels like that Talladega movie with Will Farrell. Sounds like someone is strangling a cat!

3 thoughts on “3/7/2019”

  1. Your comments and observations on the biopharm industry are priceless, because they are raw, unfiltered and informed. I check to see if you have lacerated a stock before buying and of course consider positive comments an indication that an idea merits further research. And your synopsis of academic articles is invaluable, ss I have little expertise. Classic dilemma: I want to invest but lack the knowledge to do so. Anyway, thank you.

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