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Friday, November 5, 2021

Emergent CEO: Why we’re ending pandemic manufacturing partnership with U.S. government

 This week, the U.S. Department of Health and Human Services agreed to Emergent BioSolution’s request to end our 9-year pandemic manufacturing partnership that began after the 2009 H1N1 “swine flu” pandemic. We did not come to this decision easily.

Emergent was founded to help respond to and prepare for public health threats. And even though we’re ending this manufacturing partnership with the government, our Bayview facility will continue producing COVID-19 vaccines and treatments for our private sector partners, and we will continue to supply the U.S. government with other needed medical countermeasures. We’re proud of what our hundreds of employees have been able to accomplish right here in Baltimore. As the country looks ahead to preparing for the next pandemic, I want to share with you our experience and what we learned, so the country is better prepared for the future.


The original intent of this partnership was to create a facility that could produce 50 million dose-equivalents of influenza vaccine drug substance in four months in the event of a pandemic. Facility expansion was only a first step. To build and maintain a state of readiness, continued investment is a necessity. The government maintained that they would provide us with the necessary drug development work to build and maintain those capabilities. That didn’t happen.

Fast forward to the emergence of COVID-19. The federal government sought domestic manufacturing capacity as pharmaceutical companies began trials on dozens of vaccine candidates. Despite the eight years and over $200 million of additional Emergent investment, our Bayview facility was still developing clinical-stage drug substance material, with fewer than 100 employees, and had never been tested by the government for influenza, much less a new virus. Ultimately, Emergent would hire and train more than 300 new employees and deploy never-before-tested processes and technologies to manufacture not one, but two, novel coronavirus vaccine candidates.


We had already committed to Johnson & Johnson to manufacture their vaccine candidate when the U.S. government, through the Center for Innovation in Advanced Development and Manufacturing (CIADM) program, reserved the remaining capacity at Bayview to be used at their discretion. They directed us to work with AstraZeneca. No one at the time knew which vaccine candidates would succeed. So, even though the U.S. government, we and our partners understood the risks of producing two viral-vector vaccines in the same facility, we took on the challenge.

Then, in March of this year, a single batch of the J&J vaccine was cross contaminated with the AstraZeneca vaccine. Emergent has taken full responsibility for this incident and addressed the conditions that caused it. And, thanks to the dedicated work of our employees alongside J&J, manufacturing of the vaccine resumed in late July. Despite the setback, there are approximately 100 million people in the world who are safer because of vaccine made at Bayview, with more batches still under review. We are proud of this accomplishment. As of today, except for Emergent, none of the companies selected by the Biomedical Advanced Research and Development Authority to create CIADMs have yet produced usable vaccine.


As we prepare for future pandemics, there are a few key lessons we need to take from this experience. First, we shouldn’t assume the next pandemic will be just like this one. The investment in our Bayview facility was born out of a review of the 2009 influenza pandemic. We need to take an expansive view of potential public health threats and create the capabilities to respond.

Second, we need to approach manufacturing with a military readiness mentality. Proactively producing a variety of drug substances will allow us to develop the technologies, processes, and worker expertise to manufacture whatever is needed to defeat the next pandemic.

Third, we need to invest in the jobs and training to prepare for the next pandemic. That means investing now in the people and training to manufacture the next therapeutic or vaccine that will lead us out of a future pandemic.

Many companies stepped up to help fight this pandemic, often attempting to do things that had never been done before. Not everything went perfectly. We know that firsthand at Emergent. But if you want companies to engage, you need to be willing to stand by them through both challenge and achievement. As difficult as that is, it’s essential to America’s success in combating the public health threats of the future.

Robert Kramer (ceo@ebsi.com) is president and chief executive officer of Emergent BioSolutions, in Gaithersburg, Md.


https://www.baltimoresun.com/opinion/op-ed/bs-ed-op-1105-emergent-government-partnership-end-20211104-ooalp5sb4zbczog4b3ryol5leu-story.html

Calithera to Discontinue KEAPSAKE Clinical Trial

 KEAPSAKE interim analysis demonstrated lack of clinical benefit among patients treated with telaglenastat

--Company will focus on advancing newly acquired targeted oncology compounds sapanisertib and mivavotinib, as well as the ongoing trial of CB-280 for the treatment of cystic fibrosis

Calithera Biosciences, Inc. (Nasdaq: CALA), a clinical-stage, precision oncology biopharmaceutical company, announced today the decision to terminate its phase 2 KEAPSAKE clinical trial based on a lack of clinical benefit observed in patients treated with telaglenastat in an interim analysis.

“We are disappointed in this outcome for the KEAPSAKE trial, but it was a well-run study with an interim analysis that gave us an answer to an important clinical question. We also want to express our sincere gratitude to the patients who participated in the trial and their families, as well as the physicians who served as investigators for the trial and their site staff,” said Susan Molineaux, PhD, chief executive officer of Calithera. “We remain committed to patients with difficult-to-treat cancers and will continue to advance our investigational targeted therapies for biomarker-specific patient populations. Our near-term clinical development plans include leveraging our clinical and biomarker expertise in the KEAP1/NRF2 pathway in the development of our mTORC1/2 inhibitor sapanisertib in squamous non-small cell lung cancer, as well as advancing the development of our SYK inhibitor mivavotinib in specific biomarker-defined populations of diffuse large B-cell lymphoma. In addition, we are continuing the development of our arginase inhibitor CB-280 for the treatment of cystic fibrosis.”

The phase 2 randomized, placebo-controlled, double-blind KEAPSAKE study was designed to evaluate the safety and anti-tumor activity of telaglenastat plus standard-of-care chemoimmunotherapy as front-line therapy among patients with stage IV non-squamous non-small cell lung cancer (NSCLC) whose tumors have a KEAP1 or NRF2 mutation. At the time of unblinding on October 27, 2021, there were 40 patients randomized. The available efficacy data at unblinding, including investigator-assessed progression-free survival (PFS), did not demonstrate clinical benefit, and analysis of the data led to the conclusion that there was a very low probability for the study to achieve a positive result. No difference in safety profile was seen between the two arms. The company has communicated these findings to the U.S. Food & Drug Administration (FDA) and has voluntarily discontinued the phase 2 study with agreement from members of the KEAPSAKE Steering Committee. Calithera has no plans to continue the development of telaglenastat at this time. Calithera estimates the cost savings resulting from the discontinuation of this trial will be $10-15 million.

https://finance.yahoo.com/news/calithera-biosciences-announces-decision-discontinue-110000111.html


Deciphera GI tumor therapy misses primary endpoint

 – Study Did Not Achieve Primary Efficacy Endpoint of Improved Progression-Free Survival Versus Standard of Care Sunitinib in Patients with Second-line GIST –

– Conference Call to be Held Today at 8:00 AM ET –

Conference Call and Webcast

Deciphera will host a conference call and webcast to discuss this announcement today, November 5, 2021 at 8:00 AM ET. To access the live call by phone please dial (866) 930-5479 (domestic) or (409) 216-0603 (international); the conference ID is 3072405. A live audio webcast of the event may also be accessed through the "Investors" section of Deciphera’s website at www.deciphera.com. A replay of the webcast will be available for 30 days following the event.

https://finance.yahoo.com/news/deciphera-pharmaceuticals-announces-top-line-110000876.html

Apollo Medical ups full year guidance

 Guidance:

ApolloMed is raising its full-year 2021 guidance, previously disclosed on August 5, 2021, as a result of its continued organic growth and increased risk pool settlements and incentives revenue as a result of reduced utilization at ApolloMed's partner hospitals in 2020 during the COVID-19 pandemic and a shared savings settlement of $21.8 million from ApolloMed's participation in an Accountable Care Organization ("ACO") for the 2020 performance year. Net income and EBITDA include the impact of Allied Physicians of California, a Professional Medical Corporation's ("APC") investment in a payor partner, which completed an initial public offering to become a publicly traded company in June 2021. As APC's investment is an excluded asset solely for the benefit of APC and its shareholders, any gains or losses as a result of this investment do not affect the net income attributable to ApolloMed and adjusted EBITDA attributable to ApolloMed. The November 4, 2021 revised net income and EBITDA guidance ranges assume a stock price of the payor partner of $8.49. These assumptions are based on the Company's existing business, current view of existing market conditions, and assumptions for the year ending December 31, 2021.

($ in millions, except per share information)

2021 Guidance Range


2021 Guidance Range


(as of August 5, 2021)


(as of November 4, 2021)


Low


High


Low


High

Total revenue

$

700.0



$

720.0



$

751.5



$

758.5


Net income

$

56.0



$

66.0



$

81.0



$

83.5


Net income attributable to ApolloMed

$

48.0



$

58.0



$

71.5



$

73.5


Earnings per share - diluted

*


*


$

1.58



$

1.62


EBITDA

$

100.0



$

119.0



$

139.0



$

143.0


Adjusted EBITDA

$

120.5



$

130.5



$

168.5



$

170.5


*Range was not previously provided as of August 5, 2021.

See "Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA" and "Use of Non-GAAP Financial Measures" below for additional information. There can be no assurance that actual amounts will not be materially higher or lower than these expectations. See "Forward-Looking Statements" below for additional information.

Management Commentary:
Kenneth Sim, M.D., Executive Chairman of ApolloMed, stated, "We delivered a strong third quarter, achieving 26% growth on the top line and 105% growth in net income attributable to ApolloMed primarily as a result of organic membership growth in our existing IPAs and increased risk pool settlements and incentives revenue due to decreased utilization at our partner hospitals during the height of the pandemic and the shared savings settlement from our participation in an ACO model for performance year 2020. Our ACO generated $57.7 million in gross savings during the 2020 performance year, which is the highest dollar amount saved out of all 37 ACOs in the country by a margin of over $18 million. This incredible performance is a further testament to the results being driven by our proprietary tech platform, which has increasingly improved the ability of our physicians to deliver high-quality care in a cost-effective manner over the past year. As a result of these trends and our continued organic growth, we are pleased to once again raise our guidance for the full-year 2021. Today we announced the appointment of Brandon Sim to the role of Co-CEO in what we felt was a natural transition given his growing leadership role in key areas of our business since he joined ApolloMed in 2019. The management team is well positioned with Brandon at its helm. We believe his background and ability to consistently deliver tangible results will serve the Company well in the years to come."

Brandon Sim, Co-CEO of ApolloMed, added, "I am excited to have this opportunity to continue the stellar work we have been doing here at ApolloMed over the past two years. During the third quarter, we closed a few previously announced transactions, specifically the CAIPA MSO strategic alliance and investment and the acquisition of controlling interests in Access Primary Care Medical Group and Sun Clinical Laboratories (Sun Labs). Earlier this week, we announced the signing of an agreement whereby our affiliate has committed to purchasing the remaining equity interests in DMG, a complete outpatient imaging center that has been serving patients in the San Gabriel Valley area of southern California since 1984. Our affiliate currently owns 40% of DMG and has committed to purchasing the remaining 60% within the next three years. We are pleased to be expanding upon our partnership with DMG and look forward to continuing to enhance DMG's commitment to superior patient experience while exploring potential opportunities to bring its service offerings to new markets. Our platform and growth strategy have driven the incredible results we have been able to achieve in the first nine months of 2021, and we look forward to closing the year with a strong fourth quarter."

https://finance.yahoo.com/news/apollo-medical-holdings-inc-reports-200600838.html

Sarepta upped to Overweight from Neutral by JPMorgan

 Target $130

https://finviz.com/quote.ashx?t=srpt

Novo Nordisk Wegovy shows significant, sustained weight loss in 2-year obesity study

 

  • The STEP 5 trial demonstrated an average weight loss of 15.2% with Wegovy™ at 104-weeks when used with a reduced calorie meal plan and increased physical activity vs. 2.6% with placebo

  • The trial also showed that 77.1% of study participants who received Wegovy™ lost at least 5% of their body weight, compared to 34.4% of those who received placebo

Results from the STEP 5 phase 3b trial, presented today at the ObesityWeek® 2021 interactive congress, showed that adults treated with Wegovy (semaglutide 2.4 mg injection) achieved significant and sustained weight loss over the two-year study period. The STEP 5 trial investigated Wegovy™ vs. placebo, both used with a reduced calorie meal plan and increased physical activity for the treatment of obesity (BMI ≥30 kg/m2) or overweight (BMI ≥27 kg/ m2) in 304 adults with at least one weight-related comorbidity for 104 weeks (two years).1

In the STEP 5 trial, results showed that Wegovy™ used with a reduced calorie meal plan and increased physical activity significantly reduced body weight from baseline to week 104 compared to placebo (-15.2% vs. -2.6%, estimated treatment difference: -12.6% -points [95% CI: -15.3, -9.8]; p<0.0001)1. The study also demonstrated that adults with overweight or obesity were more likely to lose at least 5% of their body weight with Wegovy™ vs. placebo (77.1% vs. 34.4%; p<0.0001).

“People with obesity try on average seven times to lose weight before seeking medical care. Once weight is lost, however, it all too often comes back, which is why it is critically important to find options to help people living with obesity lose weight and keep it off,” said W. Timothy Garvey, MD, Professor of Medicine, Department of Nutrition Sciences at the University of Alabama in Birmingham. “Results from the STEP 5 clinical trial demonstrated that adults with obesity were able to lose weight whilst taking Wegovy™ and maintain the weight loss at two years, which can help us better treat and manage obesity as a chronic disease.”

Endo Reports Third Quarter, Ups 2021 Financial Guidance

 Endo International plc (NASDAQ: ENDP) today reported financial results for the third-quarter ended September 30, 2021.

"We delivered strong third-quarter results driven by outstanding execution across all of our businesses. As a result of our year-to-date performance and our expectations for the remainder of 2021, we are raising our full-year 2021 financial guidance," said Blaise Coleman, President and Chief Executive Officer at Endo. "Additionally, we are pleased with our progress against our strategic priorities including our efforts to expand and enhance our portfolio with the recent launch of varenicline tablets, the only available FDA approved generic version of Chantix®, and the continued positive market response to QWO®."

2021 FINANCIAL GUIDANCE

Endo is updating its financial guidance for the full-year ending December 31, 2021 by raising the expected ranges regarding revenues, adjusted diluted net income per share from continuing operations and adjusted EBITDA. The guidance below contemplates a range of potential outcomes that reflect uncertainties in certain key assumptions including, among other things, uncertainties related to the COVID-19 pandemic. These statements are forward-looking, and actual results may differ materially from Endo's expectations, as further discussed below under the heading "Cautionary Note Regarding Forward-Looking Statements."


Full-Year 2021

Prior


Current

Total Revenues, Net

$2.73B - $2.79B


$2.90B - $2.94B

Adjusted EBITDA

$1.23B - $1.28B


$1.40B - $1.42B

Adjusted Diluted Net Income per Share from Continuing Operations

$2.15 - $2.30


$2.80 - $2.85

Assumptions:




Adjusted Gross Margin

~70.0% - 71.0%


~71.5%

Adjusted Operating Expenses as a Percentage of Total Revenues, Net

~28.5%


~26.5%

Adjusted Interest Expense

~$560M


~$560M

Adjusted Effective Tax Rate

~11.0% - 12.0%


~13.0%

Adjusted Diluted Weighted Average Shares

~239M


~236M


https://finance.yahoo.com/news/endo-reports-third-quarter-2021-201500240.html