Q1 Pharma Financials Published Across the sector - Guess who's in the lead?
+ a brief comment on PABS & a taster on a public health emergency you probably hadn't heard of
Dear Friend of Global Health Conversations,
(And we have a couple of new friends this fortnight - welcome!) I write to you this evening with an old Kings of Leon song playing in the background. Milk. I once read that this melancholy, salty break up song was about a lactose intolerant girl and unrequited love ❤️. Back in sunny Geneva, today I attended church online, steamed some South African turmeric rice (with sultanas 💃🏾!) and now I sit on a lovely terrace and break down the Q1 Pharma Financials to share with you. Skip to the Fortnight in Resources to see that part.
I know that for many of you reading this we are working up to a pretty busy time of year - particularly in this city.
Approaching this fortnight’s edition - I felt that I had both a lot and nothing to say about Pathogen Access and Benefit Sharing; plus digesting all the activities and outcomes within and around the INB negotiations generally. (See: here, here). I will leave my better consolidated thoughts and distilled resources for our next chat which will land in your inbox two weeks from now, the weekend before the 77th World Health Assembly. Hopefully talking points, if necessary, will be easy to extract from that one 😉.
For now, you can also catch up on last fortnight’s episode on Drug Licensing & the Pandemic Accord. I was recovering from Bronchitis in that episode - hopefully not too audibly! I’m fully recovered and will be writing to you next fortnight on my way back from a quick weekend at the F1 Monaco Grand Prix with a bonus episode in tow! It focusses on a very recent public health crisis that you might not have heard of in the US centered around a company called Real Water - whose alkaline, bottled water was the at the heart of an outbreak of non-viral hepatitis in both children and adults. It’s formatted a bit like a bonus episode from last summer - the TGN1412 UK ‘Elephant Men’ clinical trial catastrophe.
As the big kid I am, I’m hankering for a braai in this wonderful weather. Here are the other melancholy songs I’ve been listening to (a bit like the false but common caricature of a melancholy French woman) Sonder - Too Fast & Reckless (but you’re talking to a huge Sonder fan); Alicia Keys - Try sleeping with a broken heart; Into Yam - Ringo Madlingozi . And the cherry on the cake - my watch list for this week is to rewatch Les Parapluies de Cherbourg - an old favourite. And one I headed to the French cinema in London to watch in late February 2020 - in a little corner - to see one last time before the world…. ended? Finally, I’ve been reading Zainab Badawi’s new book - an African History of Africa - loving the parts I loved, and feeling indifferent to the minority that I didn’t. This fortnight I also spent some time in London, where I got my hands on an English copy of Vaccines (see Behind the Scenes). In the past 6 months, whenever I had the opportunity to hear Thomas Cueni, recently stepped down as head of the IFMA speak, he promoted this particular book. I can’t wait to get into it.
And to you, friend. I wish you a week of good rest, productivity and delicious little joyful moments with friends, family and loved ones.
With love,
Christiana
Q1 Financials Published Across Pharma
1. Diabetes and weight loss - biggest % growth!
You might recall a past newsletter where I talked all about the growth of GLP-1 semaglutide products and how they were fuelling growth in Q4 particularly for Novo Nordisk with regards to Ozempic and Wegovy. Read the deep dive here. Well, now with the 2024 Q1 financials out - in the areas of diabetes management and obesity, Novo Nordisk still takes the cake! Largely, at least. These are some incredible numbers that point to the weight of this area, not only in North America, although largely. But also worldwide. I wrote a complex piece on Obesity almost 8 years ago. And the findings still stand strong. That said, the real catalyst for this almost astronomical growth has not only been diabetes management, but also (viral) weight loss management therapeutics. These are summaries that you won’t find condensed in this way anywhere else! So have a skim, and if you have comments, I’m always contactable in response to this email. :)
1. Novo nordisk - $9.5 billion USD( 24% (-26%) increase)
Generated $9.5 billion in Q1 sales, driven by semaglutide diabetes drug Ozempic ($4 billion - up 43%) and weight-loss treatment Wegovy ($1.4 billion - more than doubled - thanks Elon Musk - see past issue for tweets) The company upped its 2024 sales outlook from 18%-26% to 19%-27% growth.
2. Lilly - whose financials were only published early last week - $8.8 billion USD (26% increase)
In Q1, Lilly, a huge winner this quarter, saw a 26% revenue increase to $8.8 billion, driven largely by Tirzepatide products, marketed as Mounjaro for diabetes and Zepbound for weight loss, which accumulated $2.3 billion in sales. This success offset a 26% decline in Trulicity sales, another diabetes management therapeutic. The key difference being that Trulicity (generic name: dulaglutide) is a single-action medication that mimics the hormone GLP-1, while Mounjaro is a dual-action medication and mimics the hormones GLP-1 and GIP. CEO David Ricks announced an extensive expansion plan to address Tirzepatide supply constraints, aiming to construct new manufacturing facilities in the U.S. and Europe. As a result, Lilly raised its 2024 revenue guidance by $2 billion to $42.4 billion-$43.6 billion, reflecting confidence in sustained growth. I found this useful graph below including Saxenda, not mentioned here.
2. Oncology - Highest Volume in figures(USD)
1. AstraZeneca: Q1 sales hit $12.7 billion (19% UP!)
Driven by their diabetes treatment Farxiga and blockbuster oncology drugs Tagrisso and Imfinzi. Due to their cancer & diabetes offerings - you’ll see that our friends ar AZ didn’t see the declines that their counterparts who made bank on COVID-19 viral vector (&mRNA) vaccines did in the same time frame. Their blockbuster oncology drugs made the most this quarter. Additionally, proceeds from partnered medicines—including Daiichi Sankyo-partnered breast cancer therapy Enhertu and Amgen-partnered asthma treatment Tezspire reached 59% rising to a pretty incredible $457 million.
2. Merck: Reported Q1 sales of $15.8 billion,
This was led by cancer drug Keytruda and Gardasil/Gardasil 9 HPV vaccine franchise. Now, do you recall that a few months back we discussed Nigeria’s incredible, near mammoth HPV drive? Partially funded by GAVI, but due to Nigeria’s high GNP status, also largely paid for by the national government and health ministry? I tried to search for specific details as to which of GAVI’s procurement partners largely supplied this deal. And I couldn’t find this. (Could you? Please write if so! 🙂) My hypothesis was that elevated HPV sales vs Q1 2023 might be due to this - Nigeria currently has the 6th largest global population. But I was unable to attribute this to any particular companies’ sales, despite Merck’s Gardasil being the most widely known and used HPV vaccine. So watch this space in coming weeks - I’m scouring my network a little for this specific information! GAVI’s bulk buying power is definitely enough to leverage any company’s sales by some good proportion.
3. BMS: Revenues reached $11.9 billion.
Lead by Eliquis, an anticoagulant blockbuster. (i.e. Useful applications for oncology)
4. Sanofi: Q1 sales grew to $11.4 billion,
Driven by Regeneron-partnered monoclonal antibody Dupixent and RSV monoclonal antibody Beyfortus. I mention this alongside the other Sanofi news this fortnight of their Chief Scientific Officer and global head of research Frank Nestle leaving the French multinational after eight years on the job.
5. BioNTech's Q1 revenue dropped 85% to $202.1 million
BioNTech’s expected nosedive was due to decreased, largely endemic level demand for COVID-19 vaccines. CEO Uğur Şahin, highlighted the company's oncology programs, aiming for 10 trials by 2024 end. The 2024 revenue outlook remains at $2.7 billion-$3.3 billion, with 90% expected in the last months.
3. Vaccines
The beautiful thing about vaccines is the ability to achieve scale. Biologics and vaccines, due to their complex manufacturing processes, as we know, are more profitable than small molecule compounds. Pretty much every time. With some exceptions I can discuss at length in the future - as a drug development scientist who moved into the biomanufacturing and bioengineering space. That said, some of our players in the vaccine space have made huge gains. And in my opinion, this is largely due to scale. Biologics for oncology, for example, in the treatment space, outside of CTs, rely on patients who are ill. Vaccines, on the other hand, when adopted by a government, particularly on their national immunisation schedule, can be rolled out at a higher scale. Attracting more doses and profits.
Reported climbing revenues driven by zoster and flu vaccines, with plans for Phase 3 trials of next-gen pneumococcal vaccine.
1. GSK: Posted $9.4 billion in sales
Vaccine sales jumped to 16%, including strong demand for RSV vaccine Arexvy and shingles jab Shingrix.
2. Pfizer
Pfizer saw a decline in Q1 revenues, but sales were driven by pneumococcal vaccines Prevnar 13/20.
3. Moderna's quarterly sales plummeted 91% to $167 million,
Moderna’s outcomes reflected the shift to a seasonal COVID-19 vaccine market. It’s easier said than done for this medium-sized pharma. The company anticipates U.S. approval for its RSV vaccine by mid-May, signaling progress towards a second product. CFO Jamey Mock restated Moderna's 2024 sales forecast at around $4 billion, expecting a rebound in sales growth by 2025.
Behind the scenes:
I’ve been up to a lot this fortnight so there are tons of fun photos to share! 1 & 13: An incredible culinary experience at a famous Nigerian London Tapas restaurant with my sister (and best friend, Alison). Highly recommended! 3: Sitting at Chiltern and spotted this lovely pair. 4, 6 & 9: This fortnight I organised a gathering of clever, creative, intelligent women for a brunch & painting workshop in London. We had an absolute blast - 9 was behind the scenes prepping gift bags with mementos from various guests businesses & projects! 5: Cruise in Geneva with Dr Miriambeth Asika. 7: Supper with fan fave, Maria Kasimati. 8: Whenever I have had the opportunity to meet & hear Thomas Cueni speak, he promoted this particular book. I can’t wait to get into it. 10: Jardin Botanique Geneve! Tourist in my hometown. 11 &12: In Windsor with Zainab Shaukat. ❤️
Recent Episodes: In case you missed them! 💃🏾
Recent Episodes: In case you missed them! 💃🏾
Episode 19: Drug Licensing and the Pandemic Accord
In this week’s episode, we look at Colombia's recent move in issuing its first compulsory license. The country challenged ViiV Healthcare's monopoly on their patented drug, dolutegravir, an HIV therapeutic, in an attempt to open doors for affordable generic versions and thus improve accessibility & affordability.
We explore the nuances of licensing mechanisms - voluntary agreements & compulsory licenses. We discuss their impact on public health and innovation, drawing parallels with past instances. We also delve into the proposed European Union-wide Compulsory Licence and industry perspectives on intellectual property. Hard subject here - and as someone who started out in Pharma I find it hard to put full advocacy behind non-market driven mechanisms. But what does the data say?
Episode 17: PART 1: Dental Dialogue: Prioritising Oral Health in Public Health (ft. Ema Prohić) & Episode 18: PART 2: Dental Dialogue: Prioritising Oral Health in Public Health (ft. Ema Prohić) - Part 2
Ema and I discuss oral health as a public health issue. Discussing system challenges, incentivisation and disincentivasation, dental caries as the most common infectious disease, bacteria and the use of antibiotics. We also discuss a public health project that I led back in 2020 with the Ministry of Health Qatar and PHCC wherein she focussed on integrating oral health into a primary care program. Ema is a doctor of dental medicine from Croatia, currently undertaking her specialization in orthodontics and facial orthopedics in Barcelona as well as working in the UK in several dental practices as an NHS and private practitioner.
Episode 16: Tackling Cervical Cancer: Health Equity in Focus (International Women's Day Special)
This episode is in recognition of International Women's Day. We talk about cervical cancer and discuss its significance as a symbol of global health disparities and gender inequality. Cervical cancer incidence is exacerbated by socio-economic factors and disproportionately affects women in poverty. We discuss the importance of HPV vaccination, regular screening, and innovative prevention strategies like diagnostic tools to enable self-sampling. And the incredible toll of the devastating disease.