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Friday, January 19, 2024

Obesity drug firms choose golden goose pricing

 Pharmaceutical companies have started 2024 off with their usual bang, raising the list prices for diabetes drugs such as Novo Nordisk’s NOVOb.CO Ozempic and Eli Lilly’s LLY.N Mounjaro, according to the Wall Street Journal. In the complicated U.S. healthcare system, these prices don’t have much to do with reality for most people, as about two-thirds of the population is covered by commercial health insurance, and those institutions negotiate to receive big discounts. But list prices matter when the similar drugs are prescribed for weight loss, where more people pay out-of-pocket. As drug pushers know, reaching the masses is ultimately more lucrative than reaching the classes.

Both Wegovy and Zepbound, the two drugs that are sold for weight loss, are listed at over $1,000 a month. Only about a fifth of employers covered prescription weight loss therapies as of last March, according to the International Foundation of Employee Benefit Plans. As a result, many patients must pay full boat for the drugs if they want to use them to get skinny.

Even with the cost, demand seems nearly insatiable. Lilly’s Zepbound grew by about 25,000 new prescriptions weekly in December, and CEO David Ricks said the company may not be able to make enough of the drug this year. For now, the producers are somewhat constrained. And Lilly and rival Novo Nordisk should be able to reap huge margins from patients who are willing to pay full boat.

Yet the two companies are offering a discount – half off to patients with commercial insurance that doesn’t help pay, roughly similar to the discount insurers typically negotiate – to pique interest while clinical results seem miraculous.

While that means fewer golden eggs today, the goal is harvesting more over time. Obesity is a risk factor in nearly every major cause of death in developed nations. The companies are gambling that as the beneficial evidence of weight loss accumulates, insurance coverage will become standard. Since weight is gained once patients stop taking obesity drugs, the lower price can get people hooked.

Patients culled today may stick around tomorrow, or come back if the pounds return. The risk is patients stop using the drugs because of harsh side effects, insurance coverage remains spotty, or better new therapies emerge and steal these patients. Given the gigantic potential size of this market, with about 40% of U.S. adults obese, it’s worth the gamble.

https://www.xm.com/research/markets/allNews/reuters/obesity-drug-firms-choose-golden-goose-pricing-53742270

'US says 'no way' forward without a Palestinian state'

 The US State Department pushed for the formation of a Palestinian state on Thursday.

Spokesperson Matthew Miller said Israel had an opportunity right now as countries in the region are ready to provide security assurances to Tel Aviv.

"But there is no way to solve their long-term challenges to provide lasting security and there is no way to solve the short-term challenges of rebuilding Gaza and establishing governance in Gaza and providing security for Gaza without the establishment of a Palestinian state."

Miller was speaking after Israeli Prime Minister Benjamin Netanyahu told Washington he objected to any Palestinian statehood that did not assure Israel's security.

"I clarify that in any arrangement in the foreseeable future, with an accord or without an accord, Israel must have security control over the entire territory west of the Jordan River. That's a necessary condition. It clashes with the principle of sovereignty but what can you do,"

These latest comments make it appear as though Netanyahu’s government is at odds with Washington, its biggest backer.

Last week U.S. Secretary of State Antony Blinken took a rough agreement to Israel that its predominantly Muslim neighbors would help rehabilitate Gaza after the war, so long as Israel committed to the eventual creation of an independent Palestinian state.

U.S.-brokered talks on a Palestinian state territory now occupied by Israel collapsed almost a decade ago.

Israel launched its siege in Gaza following October 7 attacks by Hamas militants, which Israeli officials say killed one-thousand two-hundred people.

Meanwhile, the local health ministry in Gaza says over twenty-four thousand people have been killed in Israel's assault.

https://news.yahoo.com/us-says-no-way-forward-084628366.html

'CEOs leave Davos to game out 2024 geopolitical scenarios'

 Business leaders in Davos say they are increasingly turning to scenario planning to safeguard supply chains and lessen the potential hit from unexpected geopolitical crises.

Many CEOs and executives told Reuters they foresee an upbeat U.S. economy in 2024, but are concerned about China and Europe, and the impact of unexpected global shocks on inflation.

The World Economic Forum (WEF) this year took place against the backdrop of conflicts in the Middle East and Ukraine, as well as impending elections in dozens of countries.

"Just when governments and companies get their arms around how to deal with one flare-up, another emerges," said David Garfield, Global Head of Industries, adding a big issue at board level and executive leadership level is scenario planning.

"Sophisticated companies are saying: 'What happens if raw materials for critical production cuts off?" Garfield added.

With supply chain disruptions caused by the pandemic barely in their rear-view mirrors, CEOs are now grappling with the impact of Houthi militant attacks in the Red Sea.

Many described the global situation as unusually worrisome.

"In terms of scenario planning, the last few years has upped the ante," said Ishaan Seth, Senior Partner at global consulting group McKinsey. "It is not about forecasting the future but it is about having a perspective on how the world may play out. The key is: How do you pivot an organization quickly?"

An Alix Partners survey showed 68% of CEOs report U.S.-China tensions are causing them to adjust their strategy, while 66% worry about the U.S. presidential election.

"The (board level) concerns are geopolitics and elections around the world," said BCG Global Chair Rich Lesser. "When there is so much uncertainty, CEOs and boards ask 'What can I do to be better prepared,'" he added.

Some have been looking to diversify supply chains.

'Talk in Davos of 'high for longer' as CEOs wrestle with rates'

 Business leaders and financiers in Davos this week said they are preparing for "high for longer" borrowing costs, despite markets betting on large-scale interest rate cuts this year.

Jose Minaya, CEO of global investment manager Nuveen, which manages $1 trillion in assets said markets were "likely overestimating" the extent of rate cuts by central banks and investors need to prepare for a different environment.

"The next ten years are likely going to have lower returns than the previous ten years, you haven't seen inflation in almost two decades," he told the Reuters Global Markets Forum.

The U.S. Federal Reserve is gauging whether inflation is sustainably back at its 2% target in order to lower interest rates, after 525 basis points of hikes since March 2022.

AlixPartners CEO Simon Freakley said executives globally are "hoping for the best but preparing for the worst," as company boards plan for a high-for-longer scenario, while hoping rates will come down at least towards the end of the year.

The discussion within boardrooms was around having to manage increased interest costs than previously thought and having to accommodate that within their plans and budgets, Freakley said.

"Rates will be slow to come down, and it's partly because international central banks were slow in taking them up," said Nicolai Tangen, CEO of Norges Bank Investment Management.

"You don't want to come back to some kind of 70s situation," said Tangen, who leads the world's largest sovereign wealth fund with $1.5 trillion in assets, referring to sustained hyperinflation in the 1970s.

U.S. rate-futures contracts are now pricing in a year-end policy rate of around 3.88% from the Fed's current 5.25% to 5.50% target range, and expecting rate cuts to begin in March.

"March is a very realistic starting point," said Jan Hatzius, chief economist and head of global investment research at Goldman Sachs, who forecasts five U.S. cuts for 2024.

'Iran's desire for 'a seat at the table' felt in Davos'

 At a dinner in the Swiss ski resort of Davos this week, Prime Minister Mohammed Shia al-Sudani hosted business and political leaders to showcase Iraq's improved security and finances.

As the private event was about to end, two attendees told Reuters, news reached some guests that Iran had fired ballistic missiles at what it said was an Israeli "spy headquarters" in Erbil, the capital of Iraqi Kurdistan.

"Some people at the dinner were checking if their houses have been hit," said one guest, who asked not to be named because the dinner was closed to media.

The strikes by the Islamic Revolutionary Guard Corps (IRGC) in the oil and gas rich region was the most direct intervention by Iran, and sparked fears of the Israel-Hamas conflict spreading in the Middle East.

While Iran's proxies, Hezbollah in Lebanon and the Houthi rebels who have attacked shipping in the Red Sea off Yemen, have stepped in since it began in October last year, Tehran has made it clear it wants to avoid war with Israel.

But for some at the World Economic Forum (WEF), where the agenda was dominated by three areas of conflict in which Tehran is involved, the Iraq missile attack highlighted Iran's desire to play a role in how the war in Gaza is resolved.

"The Iranians want a seat at the table," a senior source with direct knowledge of Tehran's thinking told Reuters, explaining its actions were meant to give Iran a voice and not allow the U.S. and Israel to dictate the outcome.

"The real question is 'what is the end game for Iran and Hezbollah and now increasingly the Houthis?' They don't want Israel and the U.S. to dictate the pace of (the) Gaza war," Vali Nasr, a Middle East expert at the Johns Hopkins School of Advanced International Studies, said in Davos.

"One man's escalation is another man's deterrence."

Iran's Foreign Minister Hossein Amirabdollahian, the only official delegate from the Islamic Republic in Davos, said on Wednesday that attacks against Israel and its interests by the "Axis of Resistance" would stop if the Gaza war ends.

"I'm extremely worried. I think we have both seen spread and escalation," U.N. Special Envoy for Syria Geir Pedersen said at a WEF panel on the Middle East two days after the strike.

"I do believe Iranians do not want further escalation ... I think they are playing with fire," said Pedersen, who was listed on the Iranian foreign ministry's website as one of the senior officials with whom Amirabdollahian would meet in Davos.

Amirabdollahian did not respond to Reuters questions at Davos. Iran's foreign ministry could not be reached for comment.

The United States and other Western nations accuse Tehran of supplying drones and equipment to the Houthis and Russia for its war in Ukraine, as well as funding Hamas.

Iran says it supports the Houthis but denies arming them. While publicly acknowledging selling armed drones to Russia, Tehran says it has not provided any to attack Ukraine.

KURDISTAN

The Erbil strikes also reminded the world of oil exporter Iran's deep involvement in the politics of its neighbour Iraq.

The day after, a visibly upset Iraqi Kurdish Prime Minister Masrour Barzani gathered members of his delegation and some media at the Kurdish House on the Promenade in Davos.

"What's surprising - we are not a part of this conflict. We don't know why Iran is retaliating against civilians of Kurdistan, especially in Erbil," Barzani told reporters.

A close friend of Barzani, the multimillionaire Kurdish businessman Peshraw Dizayee, was killed in the attack.

Iran defended the strikes, saying it had a "legitimate right to deter national security threats".

Baghdad has recalled its ambassador from Tehran in protest and Sudani has called the attacks a "clear aggression" against Iraq and a dangerous escalation.

Sudani's spokesman did not respond to a request for comment.

U.S. IMPACT

Be it in Davos or elsewhere, the difficulty of establishing dialogue with Iran is its involvement in conflicts via proxies.

This strategy was designed by Qaseem Soleimani, the commander of the IRGC's foreign operations force Quds who was killed by a 2020 U.S. military strike on Baghdad airport.

Iran promised to retaliate.

"His legacy lives on: a network of deniable but deployable arms-length proxies across the region," a Western executive working in the Middle East, who asked not to be named due to security concerns, told Reuters.

Soleimani was killed during the third year of Donald Trump's presidency. The former U.S. President exited a nuclear deal with Western powers in 2018 and imposed new sanctions on Iran.

Tehran's ability to fund wars hinges on its ability to generate enough oil revenue and Trump threatened to sanction all buyers of Iranian oil, slowing its exports to a trickle.

Under U.S. President Joe Biden, Tehran has steeply raised oil exports. Biden's administration says it does not intend to lessen pressure on Tehran or allow its oil to reach global markets.

Tehran now exports more than 2 million barrels per day, 2% of global supply, more than half of it to close ally China.

Biden, who polls indicate is likely to face Trump in the race for the U.S. presidency later this year, has refrained from tightening sanctions on Iran.

Energy analysts say Washington is keen to avoid a gasoline price rally, a sensitive subject in an election year. Biden has also failed to persuade Iran's arch-rival Saudi Arabia to raise oil supply amid strained relations with Riyadh.

A top European oil executive in Davos said that if Trump returns for a second term it would be a game-changer for Iran.

"If Trump returns to the White House, he will make two phone calls. One to his "friend Saudi" to ask for more oil. One to China to ask to stop buying Iranian oil or face a new trade war. Then, things may start to change," the executive told Reuters.

https://news.yahoo.com/irans-desire-seat-table-felt-143411922.html

'US banks warn costly deposits to weaken interest income in 2024'

 Four U.S. banks warned of lower interest income for this year on Friday, capping a week of dour commentary from the industry that has been under pressure from high deposit costs.

After more than a year of booking strong profits on the back of the high interest they were able to charge on loans, banks are contending with a string of challenges heading into 2024, including weaker loan growth and potentially tougher capital rules.

Rate cuts from the Federal Reserve later this year could ease some pressure on banks to raise deposit costs further. But some of the central bank's policymakers have cautioned that elevated rates may need to stick around for longer to bring inflation down to its 2% target.

"We continue to see rising deposit costs. Barring an end to the quantitative tightening and significant rate cuts, banks will face deposit pressures," said Rita Sahu and Megan Fox, banking credit analysts at Moody's.

On Friday, Regions Financial, Fifth Third Bancorp, State Street and Comerica joined peers in warning of lower net interest income (NII) in 2024.

Profits at all three banks also fell due to a one-time charge tied to the special assessment fee they have to pay to refill the Federal Deposit Insurance Corp's deposit insurance fund.

The KBW Regional Banking Index has lost 2.5% so far this week.

"For some banks struggling with high-cost funding, lower rates may help spread dynamics. In general, higher rates and a steep yield curve are good for banks," said Macrae Sykes, portfolio manager at Gabelli Funds.

"The inverted one today and the rapid rise in cost of deposits has presented challenges."

HUNTINGTON OFFERS HOPE

Huntington Bancshares forecast its 2024 NII would rise or fall 2% from 2023 levels, compared with Wall Street expectations for a nearly 1% drop.

The bank said it expects NII to trough in the first quarter, before expanding over the rest of the year. It also forecast average loan growth of 3% to 5%.

Compared with its peers, the bank's loan book is more evenly split between retail and business customers.

In the fourth quarter, however, its NII fell 10%.

https://news.yahoo.com/finance/news/us-banks-warn-costly-deposits-144556317.html

Coherus Positive Phase 2 Clinical Data on Casdozokitug, a First-in-Class IL-27-Targeted Antibody, at ASCO

  Data demonstrate early activity with casdozokitug/atezolizumab/bevacizumab; 38% objective response rate including three complete responses –

– Data support casdozo as a promising novel immuno-oncology agent with clinical activity in liver cancer that may be associated with IL-27 pathway biomarkers –

– Data support continued evaluation of casdozo with VEGF and PD-(L)1 blockade in HCC, including further clinical development to evaluate casdozokitug/toripalimab/bevacizumab –

https://www.globenewswire.com/news-release/2024/01/18/2811956/33333/en/Coherus-Presents-Positive-Phase-2-Clinical-Data-on-Casdozokitug-a-First-in-Class-IL-27-Targeted-Antibody-at-the-2024-ASCO-GI-Cancers-Symposium.html