Rivipansel Sodium

生物医药行业总是风云变幻。 2022年，辉瑞公司年收入突破千亿美元，成为全球营收最多的制药企业。然而，随着新冠疫情迅速退潮，2023年营收下降了41%，营收排名也从第一跌到了第四。 近日，著名的激进投资机构Starboard value携10亿美元入股辉瑞，将给这家制药巨头带来怎样的改变？ 01 千亿美元大厂 1849年，Charles Pfizer和Charles Erhart在纽约创立了辉瑞公司，最初以生产化工产品为主。二战期间，辉瑞成功量产青霉素，又推出了土霉素，正式进军制药行业。此后，辉瑞通过研发和并购不断扩张，推出了如络活喜、万艾可等重磅药物，并逐渐成为全球领先的制药企业。 进入21世纪以来，辉瑞从2001年到2013年连续蝉联全球制药企业50强（Pharm Exec Top50）榜首，被称为“宇宙药厂”。 2020年，COVID-19新冠病毒席卷全球，辉瑞与BioNTech合作，迅速推出了mRNA COVID-19疫苗Comirnaty，又自主开发了新冠口服药物Paxlovid。 图片来源：参考资料 凭借这两款新冠产品的畅销，2021年辉瑞销售收入达到720.43亿美元，2022年辉瑞公司的收入更是突破了千亿美元，达到了1003亿美元，创下了公司174年历史上的最高纪录。 其中COVID-19疫苗Comirnaty在2022年的销售额为378亿美元，新冠口服药物Paxlovid在2022年的销售额为189亿美元，新冠相关产品收入合计567亿美元。 但是，疫情很快发生了变化，2023年新冠产品的销售额并没有如辉瑞预计的那样继续畅销。 2023年，Comirnaty和Paxlovid合计销售额125亿美元，远低于辉瑞管理层预计的215亿美元。而2024年，这两款产品的继续大幅下降，没有实现辉瑞预期额增长。 或许是新冠疫情变化太快，辉瑞应对不足，导致营收大幅下降，2023年全年收入585亿美元，同比下降41%。 资本市场上，辉瑞目前股价不到30美元，比2021年12月高点的近60美元，降低了50%，甚至略低于疫情前的水平。 02 质疑声起 近日，Starboard准备了一份关于辉瑞的投资者峰会演示文稿，讨论了辉瑞的市场表现、研发管线、以及并购投资等。 首先，他肯定了辉瑞在新冠疫情中做出的贡献，但他认为，辉瑞的之后表现落后于同行和市场，包括研发管线不及预期、巨额并购没有带来预期的回报等。 在研发方面，辉瑞曾在2018年定下未来5年内推出15个“重磅炸弹”的目标，然而回看这些管线，辉瑞遇到了不少挑战。 图片来源：参考资料 过去几年，辉瑞除了在新冠产品上的成功，还推出了不少创新药，例如： Vyndaqel(tafamidis meglumine)是辉瑞开发的一款口服TTR稳定剂，于2019年获得美国FDA批准，是首个也是唯一一个治疗ATTR-CM的药物。2023年Vyndaqel系列药物销售额为33.2亿美元，今年上半年该药销售额24.6亿美元，同比增长68%。 PCV20（Prevnar 20，20价肺炎球菌结合疫苗）成功接替了PCV13，成为辉瑞业绩的一大亮点。 RSV疫苗Abrysvo在2023年5月获批后，首年即产生了8.9亿美元的收入。 但是，不达预期的项目也有很多。例如，Bavencio虽已获得监管机构批准上市，但距离“重磅炸弹”门槛（10亿美元）还尚远。而且辉瑞在2023年3月终止了与默克的合作，并将相关权益转交给默克。Cibinqo(JAK1)、Litfulo(JAK3)两款自免新药放量也较慢。 另外，C.Difficile疫苗、Rivipansel、Tanezumab等新药未能顺利获批上市，而且其重磅乳腺癌药Ibrance一项III期研究结果不佳。 而在热门领域，Bourla将GLP-1项目视为潜在的100亿美元产品。但由于安全性等问题，辉瑞终止了第二代小分子GLP-1R药物lotiglipron(PF-07081532)的开发。Danuglipron（每日口服两次）也因为副作用导致的高退出率。而后，辉瑞又推出了每日口服一次的改良版danuglipron，目前其用于治疗型糖尿病和肥胖两个适应症均处于临床Ⅰ期。另一款口服小分子GLP-RA药物PF-06954522也还处于临床Ⅰ期，进度落后于竞争对手。 在并购方面，辉瑞在新冠产品获得充沛现金流后，其“巨额并购”的基因觉醒，斥资430亿美元收购ADC公司Seagen。疫情以来，辉瑞用于并购的资金更是高达700亿美元。 表1 辉瑞的部分巨额并购 数据来源：辉瑞官网以及公开信息整理 但是，这些并购没能带来预期中的回报。Seagen在2024年上半年，为辉瑞带来了15.87亿美元的收入。但这与辉瑞此前预测的“到2030年，Seagen系列产品有望贡献超100亿美元的年销售额”还有不少距离。 另外，辉瑞在2022年以54亿美元的价格收购Global Blood Therapeutics，获得了镰状细胞病药物Oxbryta（voxelotor）。但近日，出于对患者最佳利益考虑，辉瑞从全球市场撤回了这款药物。 祸不单行，2022年辉瑞以5.25亿美元收购ReViral，获得的两个RSV候选药物Sisunatovir和RV-299（RSV N蛋白抑制剂）也相继被辉瑞从管线中剔除。 03 转折将至？ 辉瑞无论是自研，还是外部引进的管线似乎都遇到了不小挑战。而新冠疫情又变化太快，辉瑞新冠产品没能给公司带来预期的收入，针对辉瑞的质疑声越来越多。 此时，Starboard value携10亿美元入股辉瑞，虽然其股票占辉瑞总市值不到1%，但其可以通过各种方式说服其他股东加入自己的阵线，迫使管理层调整策略。 据悉，Starboard Value由杰夫·史密斯（Jeff Smith）创立，风格强势，是华尔街最令人“畏惧”的激进投资机构之一。其通常的投资策略是，持有公司部分股权，力图对公司管理层和董事会施压，推动公司进行战略调整、削减成本、推动并购和改革，以优化运营效率，提升价值，为股东带来更高回报。 这一次，Starboard Value问责辉瑞，指出导致其市值下跌的一系列原因，包括内部研发不顺利、管线估值低、巨额并购回报有限、未能达到预期的业务目标等问题，并敦促辉瑞降本提效，调整策略。 实际上，辉瑞早已开始调整，2023年辉瑞宣布削减40亿美元开支的计划，今年5月又公布了一项新计划，到2027年底再削减15亿美元开支。基于这两项计划，辉瑞在去年和今年都进行了多次裁员。 在人事上，辉瑞也频繁调整，聘请了前诺华美国肿瘤业务的高级副总裁Tina Deignan担任肿瘤学商业化负责人，以帮助公司实现到2030年销售8种重磅药物的目标。另外，辉瑞首席科学官兼研发总裁Mikael Dolsten博士也将离职，辉瑞正在寻找研发部门的下一任负责人。 无论是否受制于Starboard Value的压力，辉瑞都已开始改变，相信在不久的将来，我们将看到这家制药巨头的新面貌。 参考来源： 1.https://www.fiercepharma.com/pharma/starboard-wants-hold-pfizer-leadership-accountable-overpaid-ma-deals-poor-return-rd 2.https://www.pfizer.com/news/press-release/press-release-detail/tim-buckley-elected-pfizers-board-directors 3.辉瑞：2024 Active-Passive Investor Summit 声明：本内容仅用作医药行业信息传播，为作者独立观点，不代表药智网立场。如需转载，请务必注明文章作者和来源。对本文有异议或投诉，请联系maxuelian@yaozh.com。 责任编辑 | 小月石 转载开白 | 马老师 18996384680（同微信） 商务合作 | 王存星 19922864877（同微信）  阅读原文，是受欢迎的文章哦

Pfizer has announced an important decision to voluntarily withdraw all approved OXBRYTA® (voxelotor) lots for the treatment of sickle cell anemia (SCD) and to suspend clinical trials of voxelotor worldwide and its expanded access program. This move follows a review of recent clinical data showing that the overall benefit-risk ratio of OXBRYTA in the treatment of sickle-cell anemia no longer supports its continued use in the market. Specifically, the drug does not effectively manage complications and reduce the risk of death, and may increase the risk of serious adverse events such as vascular occlusive crises. Looking back, Pfizer paid as much as $5.4 billion to acquire this product, which has been successfully launched, and has high hopes for it. However, the rapid delisting of OXBRYTA has undoubtedly dealt a heavy blow to Pfizer's presence in this area, clouding the prospects for its sickle cell anemia treatment. Pfizer's investment in sickle cell anemia is based on the broad market demand for the disease. Although the incidence is low in developed countries, around 4.5 million people worldwide are affected by the disease, and more than 45 million carry the sickle cell gene. This large patient population provides Pfizer with significant market potential. As a result, Pfizer started laying out several years ago and acquired Global Blood Therapeutics (GBT) in 2022 for $5.4 billion, with OXBRYTA as one of its core products. However, although OXBRYTA inhibits sickle hemoglobin polymerization by enhancing hemoglobin's affinity for oxygen, thereby alleviating hemolytic anemia, its market performance has not met expectations. It is important to note that Pfizer's setback in sickle cell anemia is not an isolated event. The company also recently ended two late-stage clinical trials of another drug candidate, inclacumab, due to patient recruitment difficulties. This series of events shows that Pfizer's exploration of the sickle cell anemia market has not been easy. Still, Pfizer said it does not expect OXBRYTA's delisting decision to have a material impact on its financial outlook for 2024. This statement reflects Pfizer's steadiness and rationality in responding to market changes. From a larger perspective, Pfizer's failure in sickle cell anemia is also an inevitable result of increased competition in the industry. In recent years, with the rapid development of gene therapy and FDA approval of multiple gene therapies for sickle cell anemia, such as Vertex and CRISPR Therapeutics' Casgevy and Bluebird Bio's Lyfgenia, traditional medicines have faced unprecedented challenges. These gene therapies, which directly correct gene defects to achieve the goal of disease treatment or even a one-time cure, bring new hope to patients with blood diseases. Although gene therapy shows great potential in the field of medicine, its high cost remains a major challenge that cannot be ignored. For example, Vertex and CRISPR's Casgevy are priced at $2.2 million, while Bluebird Bio's Lyfgenia is priced at $3.1 million, sparking widespread social concern and deep concerns about its accessibility. In fact, most gene therapies cost more than $1 million, with some treatments costing as much as $3.5 million. Earlier this year, after an in-depth review by the Institute for Clinical and Economic Review (ICER), it was noted that a reasonable balance of cost-effectiveness could be achieved if Vertex and bluebird therapies were priced in the range of $1.35 million to $2.05 million. However, we should also face up to the whole new era created by cell gene therapy in the field of blood disease treatment, and its contribution and value cannot be ignored. Pfizer's recent failure in sickle-cell anemia once again highlights the complexity and uncertainty of the pharmaceutical industry. While Pfizer has long considered sickle-cell anemia products a strategic priority, its experimental drug rivipansel failed to perform as expected in the pivotal Phase III clinical study RESET, ultimately forcing the company to make a strategic change. In order to compensate for this deficiency, Pfizer chose to further improve its product line through mergers and acquisitions. Thanks to strong sales of COVID-19 vaccines, Pfizer now has ample financial firepower to fund its M&A strategy. However, "money for medicine" is not a long-term solution. As the dividend of COVID-19 gradually fades and the focus of the industry continues to shift, Pfizer has to face the reality of lower revenue expectations. Since the beginning of 2023, Pfizer shares have fallen by nearly half, from nearly $57 to $28.93. In response, Pfizer has launched a "cost reduction program" and plans to achieve $4 billion in savings by the end of 2024, $500 million less than previously expected. Company executives said the cost cuts will focus on research and development, but also involve optimizing sales and administrative functions. Entering the "post-COVID-19 era," Pfizer is experiencing unprecedented challenges and volatility. The decision to completely abandon the sickle cell anemia product line is not only a positive response to the current difficult situation, but also an important step in Pfizer's pursuit of greater certainty. However, in the face of the great pressure of competition from large manufacturers and the constantly changing industry environment, Pfizer's transformation road still has a long way to go. Whether it can find new growth points and achieve sustainable development in the future is still a problem worthy of attention.