Slides fra Krogsgaard Thomsens praesentation kan findes her:
https://jpmorgan.metameetings.net/events/hc20/sessions/29809-novo-nordisk
Det er de samme slides som fra kapital-markeds-dagen:
https://www.novonordisk.com/investors/CMD2019.html
Jeg kan ikke vedhaefte slides, fordi jeg ikke kan uploade jpeg-billeder til forum.
Det er altid interessant at lytte til konkurrentens kritik. Her en samtale med direktoeren fra Lilly:
Eli Lilly and Company's (LLY) CEO Dave Ricks Presents at 38th Annual JPMorgan Healthcare Conference (Transcript)
https://seekingalpha.com/article/4316909-eli-lilly-and-companys-lly-ceo-dave-ricks-presents-38th-annual-jpmorgan-healthcare-conference?part=single
Question-and-Answer Session
Q - Chris Schott
Okay, great. Maybe starting out on diabetes, this is an important driver for your business. It's also been a controversial market and I think access and pricing seem to be a constant conversation here. Along those lines, I feel like from investors, there's this perception that diabetes at - since it's competitive is a challenging category. So can you maybe just talk about where is the street getting that wrong and how you're thinking about diabetes as a category?
Dave Ricks
Yeah, good question. We feel probably a disproportionate number of questions in investor meetings about diabetes pricing and it does seem like there is price pressure. It is strange that at the same time there's so much criticism about high pricing in diabetes. In fact, we're in a deflationary period for pricing on a net basis and we've communicated that pretty clearly through time. But it is an area where I think demystifying it could help. First of all, there had been precipitous price events and certain categories in diabetes through the years. We were part of one of those in the early part of the last decade with rapid-acting insulin. These are scenarios where payers haven't been able to take advantage of either commoditizing a class and creating an auction environment or a new entrant comes that changes in a category, the dynamic.
Mostly this last 10 years we've been that new entrant change in the dynamic, whether it would be in DPP4s, SGLT2 or in the case of GLP. Our goal is not to deflate pricing and doing that, but rather to prove the value of our products. Right now as it lays out, we do see low single digit headwinds across all diabetes categories in terms of just the negotiation process to maintain access and reimbursement, which as of today for our brands is exceptional over 90% of the lives for both Jardiance and Trulicity, insulin is more like 50%, but that's based on the bifurcated nature of that market. We see that access point is stable with a slight headwind on pricing. We don't see ahead of us one of those precipitous events. We can always be surprised, but that's really what's been causing some of that I think the surprises investors worry about.
We feel good about where we are. And it's important to understand the underlying dynamics behind the categories we're in. Insulin we see as a relatively flat marketplace on volume, whereas GLPs are growing closer to 30% right now and SGLT2s over 20%. So although there may be a few points swing either way on price, we're doing well on share. The most exciting part about those categories, which Lilly's over exposed to in diabetes, is the underlying class growth, really changing diabetes care for so many people.
Chris Schott
It's a great point. I mean, I think about Trulicity, it's really emerged as the key growth driver of the company. You mentioned the volume growth that you're seeing. Where do we stand right now in terms of GLP-1 share as we think about relative to basal insulin as an example? And where do you think that can go over time?
Dave Ricks
Yeah, great question. I mean most people get onto a GLP injectable primarily. Now, there's an oral option after failure of the traditional small molecule orals. That we see that as the persistent trend for some time now and will continue going forward.
If we look at the totality of patients on a first line injection, about one third are on GLP, two thirds on basal insulin. But if we look at new patients who are entering that category, it's more like half, half. So that would predict that GLP share of that patient group will grow and perhaps grow by as much as 50% over the next couple of years. We're very optimistic about where that class can go. And of course we believe Trulicity is extremely well positioned with really a best-in-class CV data. The easiest use experience for patients and we know Type 2 diabetes is difficult to manage. People want an easy experience.
And this year two important events that REWIND data becoming part of our label, which remember is both primary and secondary cardiovascular prevention, risk prevention as well as the high dose. Trulicity both the three and the four and a half doses, which allow people to stay on Trulicity longer as they progress through their disease.
Chris Schott
Seems like a nice runway ahead for the product.
Dave Ricks
Yeah.
Chris Schott
Competitively it seemed like the last year, year and a half, there's a lot of focus on Ozempic versus Trulicity. The company, the product grew nicely through, through that launch. Now it seems like the concern is on Rybelsus and what's going happen with oral sema. So just perspective as we have an oral entering the market and what that means for Trulicity?
Dave Ricks
Well, its early days. I think the characterization as, the promise of an oral pill, but with the benefits of GLP is probably overstating, where that product is. It's more part of the GLP class. And I think in that we, what we've seen so far is probably what we'll see going forward, which is there is an uptick in the growth of people starting on GLPs, both injectables and the new oral form. And they are gaining share, to some degree at the expense of Trulicity, but mostly at the expense of other GLPs in particular from that same manufacturer.
So, look, its part of the environment we'll compete in. It's far from an existential threat for us. It's an important addition for doctors and patients, but Trulicity we think is the best in class solution for GLP. As I said, we've got some new events coming this year with new data and dosage. And then by the end of the year, our next generation incretin tirzepatide will begin to get Phase III data. And that'll be a very exciting moment.
This promise is to really move in a profound way, not seen before, both HbA1c efficacy as well as weight loss, which is what doctors are looking for.
Chris Schott
It seems like tirzepatides, there has been a lot of enthusiasm around that asset. Any change in confidence at all in that program?
Dave Ricks
Yes, I'm more confident in that program. I think one, one would worry that, with anyone does, with any Phase III start that as you increase exposures rather dramatically. And right now we have thousands of patients, in that program recruited already. I think there'll be 7,000 in the diabetes program. And we're well on our way toward that. So every day is you have that kind of exposure, you can uncover what is always a chance that there's some off target side effect or something you didn't expect and we haven't seen that. So I think we'd be more confident today. We've also been successful recruiting and getting these studies done. So the timeline risk is relatively low at this point.
Chris Schott
That's great. More broadly I guess as we're thinking about patient affordability, this seems like a key issue in diabetes and probably more broadly across this space. I guess when you think about what Lilly is doing and what the industry is doing, what, what more can be done to address this, this challenge across within the drug industry?
Dave Ricks
Yes, thanks for the question. I mean it is, we spend a lot of time on this and clearly it is a challenge across the drug industry. It's also a challenge across the healthcare industry. We've worked ourselves into a spot that is difficult to get out of. We've built insurance designs that make insurance more affordable for more people but have less benefit for those that are sick.
And that's particularly true with the area of pharmaceuticals where in an area like diabetes, in many cases, transactions where diabetic patients are processing through insurance a purchase of a medicine, there's subsidizing people who are well with that purchase. So we have to get out of that situation. I think that's probably a principle many people would agree with, but it's hard to do because you're then faced with the tough math of rising premiums.
In the meantime, what we need to do as manufacturers is work for our own solutions in the short term. What can we do to plug the holes where people find themselves in difficult circumstances where their deductibles or copays are very high, can we help? Of course in commercial insurance we can do a lot and we do, in government programs that's more difficult. We have also undertaken steps, to fill the gaps where people really don't have insurance, indigent care programs.
We have a Lilly Diabetes solution center where if you're up to four times the federal poverty level, you can receive a free insulin and other diabetic supplies, if you qualify for that program. And then, we've of course launched the half-price authorized generic forms of our bestselling insulins two more today, with the idea that people who find themselves, particularly in a Part D setting, where their co-payment is linked to list price, it literally cuts their copay in half.
We still would like more of our partners in the supply chain to list and carry those products, but, that's something we can do ultimately reform to the insurance system. So we avoid these upside down economics for patients. And I think more transparency throughout the drug pricing system are the path forward and we're for both those things and we'll try to be a constructive partner with everyone else who comes to this conference to try to solve those problems.
Financial calendar 2020
https://www.novonordisk.com/content/Denmark/HQ/www-novonordisk-com/en_gb/home/media/news-details.2224485.html
5 February 2020 Financial statement for 2019 and Annual Report 2019
2020-01-13:
Fauna Bio and Novo Nordisk enter into Research Collaboration to Discover Novel Therapeutics for Obesity
https://www.prnewswire.com/news-releases/fauna-bio-and-novo-nordisk-enter-into-research-collaboration-to-discover-novel-therapeutics-for-obesity-300985410.html
2020-01-02:
Novo Nordisk's new insulin affordability offerings now available in the US
https://www.prnewswire.com/news-releases/novo-nordisks-new-insulin-affordability-offerings-now-available-in-the-us-300980178.html
