Biotech Values

[DewDiligence]

More musings on CHECKMATE-026 trial/NYT write-up:

http://www.nytimes.com/2016/08/06/business/lung-cancer-drug-opdivo-fails-clinical-trial-to-expand-use.html

Not a bad synopsis, but author Andrew Pollack could have gone further by saying that Opdivo and Keytruda are very similar drugs (not merely members of the same class), and hence there’s no credible thesis for why Opdivo wouldn’t work well in first-line NSCLC among patients with sufficiently high PD-L1 expression.

Further, I don’t expect the economic harm to BMY from CHECKMATE-026 to be nearly as large as Pollack implies. We may presume that MRK’s Keytruda will soon be approved for monotherapy in first-line NSCLC for patents with >=50% PD-L1 expression, based on the results of the KEYNOTE-24 study (#msg-123339268). Hence, such patients are not going to use first-line chemo anymore, and third-party payers won’t be able to restrict such patients to cheap generic chemo regimens. Inasmuch as Opdivo and Keytruda have similar prices, payers won’t have any particular reason to oppose (off-label) Opdivo use in first-line NSCLC.

All told, in due course I foresee Opdivo and Keytruda dividing the NSCLC market roughly evenly rather than the lopsided win for Keytruda that some investors and analysts are now predicting.