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CEO Jon Congleton explained the PPI interaction is an exposure issue, not safety, as acidity affects bioavailability, and suggested physicians could monitor and adjust dosage if needed. He affirmed high confidence in the 24-hour blood pressure control, citing robust morning trough measurements from four trials. For the OSA study, he noted the goal is to improve AHI and nighttime blood pressure, with data anticipated in 2026.

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Executive Jon Congleton responded that while the 47,000 physicians represent an efficient initial target, a partner is crucial to maximize lorundrostat's value ex-U.S. and to broaden reach within the U.S. He identified the primary NDA gating factor as the completion of the 52-week open-label extension study for a majority of subjects, with a key pre-NDA meeting with the FDA scheduled for Q4 to gain clarity on submission timing.

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David Ricks, Chair and CEO, stated that Lilly will continue to price to value, anticipating single-digit net price erosion typical for chronic medications. He stressed the patient safety risks of compounding and called for stronger regulatory enforcement. Ricks also confirmed Lilly will continue offering consumer-level pricing through channels like LillyDirect to address coverage gaps.

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Dr. Dan Skovronsky, Chief Scientific Officer, stated that Lilly has high aspirations for Ebglyss, supported by strong clinical data. He noted good early uptake, with physicians reporting positive results in severe patients and subsequently moving the drug into first-line use. Regarding access, he reiterated earlier comments that coverage is growing and expressed confidence in overcoming any competitive rebate challenges.

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An executive stated that while margin expansion is guided for 2025, reaching the high 40s or 50% is not considered a good way to drive sustainable growth, as it would require under-investing in R&D. The low 40s range is seen as the right balance.

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CEO David Ricks acknowledged the long-term importance of oral drugs for market scale but noted orforglipron's launch is still some time away. He reiterated that compounding is a patient safety issue, not a financial crisis for Lilly, and that the FDA's analysis is product-specific. Since tirzepatide is not in shortage, he argued mass compounding should not be permitted.

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Co-CEO & Co-Founder Josh Cohen addressed the market size, citing Dr. Craig's estimate of 160,000 patients with 'medically important PBH' and a subset of 30,000 with 'critical PBH.' He also reiterated confidence in completing trial enrollment by year-end, with data expected in 2026.

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President and CEO Frank Watanabe clarified that Arcutis's business development strategy focuses on leveraging its best-in-class development capabilities for differentiated, development-stage assets, not on acquiring on-market revenue. Chief Commercial Officer Todd Edwards addressed Q3 guidance, stating the company anticipates continued sequential growth, though the rate will be moderated due to typical market seasonality before returning to robust growth in Q4.

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Todd Edwards, Chief Commercial Officer, stated that he does not anticipate meaningful cannibalization, expecting instead a broader use of the ZORYVE portfolio as clinicians choose the best formulation for the patient's specific needs. He noted that with 80% of psoriasis patients having scalp involvement, foam utilization should increase. He reiterated that while some seasonality is expected, the 'portfolio effect' of prescribers using ZORYVE across indications will continue to drive strong demand. CEO Frank Watanabe added that it's unlikely existing cream patients will switch, but new starts may favor the foam, especially since competitors lack a good scalp formulation.

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Chief Commercial Officer Todd Edwards provided refill rates of approximately 40% for psoriasis cream and 38% for seborrheic dermatitis foam, with tubes per patient per year expected to be around 2 for cream and 2-3 for foam. Chief Financial Officer David Topper stated the company is 'very comfortable' with the 2025 consensus revenue of $280M-$285M, while cautioning about typical Q1 gross-to-net headwinds from deductible resets.

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Chief Commercial Officer Todd Edwards confirmed there was no inventory stocking in the quarter. He attributed the strong gross-to-net improvement to a higher percentage of paid prescriptions, efficient prior authorization processes, and lower patient deductibles. Regarding Medicare, he noted that while discussions are positive, the Inflation Reduction Act has slowed PBM operations, delaying 2024 coverage wins, but the company expects to secure coverage in 2025.

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David Meeker, Chairman, President & CEO, expressed high confidence in the long-term, steady growth of BBS, which he sees growing for decades as new global markets are added. He described AHO as a larger opportunity with a potentially steeper ramp due to its specialty-like nature, but still characterized by steady, long-term growth rather than an explosive launch. He believes the AHO epidemiology could ultimately prove to be larger over time.

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David Meeker, CEO, stated his hope is for bivamelagon to show efficacy north of a 10% weight reduction, which would establish it as a viable drug, and that the company would move aggressively into Phase III for HO if data is positive. Regarding PWS, he noted the biology is relevant but the disease is complex. He believes there is a legitimate 50-50 chance of success and that any meaningful weight loss would be significant, as nothing currently helps these patients lose weight.

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CEO David Meeker explained that HO uptake should be faster than for BBS due to a concentrated, diagnosed patient base, though reimbursement remains a factor. He theorized that setmelanotide aims to restore physiology to the pre-injury state, suggesting it would not address pre-existing obesity but would still be a major health restoration.

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EVP, Head of International Yann Mazabraud confirmed the local French data will help with uptake in France and Italy and could spur named patient sales in other countries. Chairman, CEO and President David Meeker stated that for RM-718, they plan to submit toxicology data to the FDA and target first patient dosing in Q1 2025. For bivamelagon, enrollment is now over 50% complete, with full enrollment expected in Q1 2025, making a mid-year data readout possible.

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EVP & General Counsel Roy Papatheodorou confirmed the U.S. compound patent for Dupixent expires in 2031 but noted a portfolio of other patents extends well into the 2040s. EVP & Head of R&D Houman Ashrafian stated that while the current focus is on amlotelimab monotherapy, the OX40 ligand mechanism opens future combination possibilities.

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Executive Houman Ashrafian highlighted the Dupixent COPD launch, the potential of itepekimab for former smokers, amlitelimab's progress, and the internally generated bispecific lunsekimig. CEO Paul Hudson expressed excitement for all Phase II programs, specifically mentioning the game-changing potential of itepekimab in COPD and tolebrutinib in primary progressive MS.

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Brian Foard, EVP and Head of Global Hub, Specialty Care GBU, stated that while the Dupixent COPD launch will begin this year, most of the growth is expected in 2025, leveraging their existing relationships with the physician population. Houman Ashrafian, EVP and Head of R&D, identified Type 1 diabetes and transplant rejection as the most obvious biological fits for the CD40 ligand asset beyond MS.

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EVP & Chief Commercialization Officer Adam Lenkowsky responded that COBENFI is outperforming all historical launch benchmarks in schizophrenia, making analogs less relevant. EVP & CFO David Elkins addressed margins, stating that while currently pressured by legacy product declines, they are expected to improve long-term, driven by the growing, higher-margin new product portfolio.

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CCO Adam Lenkowsky expressed confidence in maintaining leadership with Camzyos, citing a strong base, high persistency, and a lack of meaningful clinical differentiation in competitor data. CMO Samit Hirawat explained it's too early to determine the read-through to HFpEF, as the diseases are different and key biomarkers have historically tracked differently in HFpEF studies.

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CCO Adam Lenkowsky reported positive feedback on Cobenfy, noting that tolerability issues like nausea are manageable as physicians are titrating doses more slowly in the real world. CMO Samit Hirawat positioned novel orals like iberdomide as crucial for the community setting, where complex cell therapies are difficult to administer, and can be combined with or replace older standards of care.

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Head of Global Drug Development Samit Hirawat expressed excitement for the CD19 cell therapy data, outlining key metrics to watch. He also contrasted the single-treatment CAR-T approach with repeatable bispecifics. Chief Commercialization Officer Adam Lenkowsky confirmed the IRA impact is seen as net neutral, with favorability for Eliquis being offset by negative impacts on Revlimid and Pomalyst.

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EVP of Oncology Business, David Fredrickson, outlined Enhertu's growth path via new indications like DB-09 in the frontline setting, expansion in the ultra-low segment, and future combinations. CEO Pascal Soriot and EVP of BioPharmaceuticals Business Unit, Ruud Dobber, detailed the obesity strategy, focusing on addressing the metabolic syndrome with a differentiated portfolio of oral agents and combinations, targeting central fat and associated risk factors rather than just cosmetic weight loss.

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CEO Pascal Soriot responded that aligning small molecule incentives would be a positive development for the industry and for AstraZeneca's pipeline, including camizestrant. EVP, Oncology R&D, Susan Galbraith explained that DB09's success against a strong three-drug regimen demonstrates Enhertu's power, which provides confidence for its potential to improve upon current standards of care in the upcoming adjuvant (DB05) and neoadjuvant (DB11) trial readouts.

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EVP, Oncology Business Unit, David Fredrickson, expects more robust sequential growth for Enhertu in H2, citing its 'early innings' status and pending guideline updates. CEO Pascal Soriot detailed a holistic 'cardiac, kidney, metabolism' strategy, segmenting the market into 'weight management' for oral therapies and 'obesity' for titrated combinations, expressing high confidence in the plan.

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CEO Vasant Narasimhan explained that while the HS hypothesis for inalumab did not prove successful, it does not diminish the company's conviction in the drug's potential in B-cell-driven diseases like Sjogren's and lupus. He emphasized that learnings across multiple platforms (BTK, anti-BAFF, CAR-T) are advancing their overall strategy in B-cell management.

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CEO Vasant Narasimhan responded that the company feels very good about its existing cardiovascular pipeline, which includes Leqvio, pelacarsen, and the recently acquired abMAA. While always evaluating opportunities, he stated there is no particular focus on bolt-on deals in the cardiovascular space at this time.

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CEO Vasant Narasimhan expressed significant excitement for Ianalumab in both immunology and hematology. He highlighted the Sjogren's readout as a foundational catalyst, followed by lupus and ITP. He noted that with six Phase III studies running, the drug has the potential to be a very significant, and likely underappreciated, medicine for the company.

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CEO Vasant Narasimhan stated that Novartis will not pursue a 'fast follower' strategy with GLP-1 type mechanisms, viewing the market as difficult to penetrate late due to the entrenchment of incumbents. Instead, the company's focus is on developing next-generation, differentiated medicines. This includes long-acting agents, new mechanisms for muscle sparing, or centrally acting pathways, reflecting a disciplined approach learned from past experiences like its late entry into PD-1 inhibitors.

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CEO Grant Pickering explained that both the VAX-24 and VAX-31 infant programs are advancing in parallel, with VAX-24 data arriving first. The ultimate strategy will be informed by the strength of the upcoming VAX-24 data. EVP & COO Jim Wassil highlighted the significant opportunity in otitis media, noting VAX-31's superior serotype coverage (~90% vs. ~40% for PCV20) could make a post-approval efficacy study both feasible and highly compelling.

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