Showing posts with label Vivus. Show all posts
Showing posts with label Vivus. Show all posts

Saturday, 21 September 2013

The Biggest Loser: A Compelling Short Opportunity In Vivus

Short Recommendation for Vivus (VVUS)

Current Price: $10.12

Target Price: $6

Horizon: 3-12 Months

Situation Analysis:

Sell side analysts have a mean price target of $13 on Vivus. This price target is based on a discounted cash flow, with projected sales of Vivus's lead drug Qsymia in the hundreds of millions by FY 2014. I differ and believe the ramp up will be slower than expected and am projecting lower revenue than the sell side, which will drive down the stock price. I also believe competition in the weight loss drug market will erode peak sales of Qsymia. The weak sales from the launch of Qsymia is also likely to mitigate the chance of a major pharmaceutical partner emerging or at least substantially delay it. I also see opportunity for Belviq to outpace Qsymia TRx (Revenue) which it has recently. I am interested in this company, because this company is trying to build a new market and because of that there is a lot of uncertainty around their prospects and therefore inefficiency

Potential Catalysts(How We Get Paid)

*Safety issues and negative side effect profile

*Inability or substantial delay in Vivus finding major pharmaceutical partner

*Intense completion from new drugs and existing competitor Arena Pharmaceuticals (ARNA)

*Weak sales of Qsymia

*Dilution from recent and future financings

*Insider Sales

*Lack of reimbursement improvements

Company Background:

VIVUS is a biopharmaceutical company dedicated to commercializing and developing innovative therapies to address unmet needs in obesity, sleep apnea, diabetes and sexual health. Their drug, Qsymia (phentermine and topiramate extended-release) (formerly known as Qnexa®)was approved by the FDA for the treatment of obesity as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adult patients with an initial body mass index, or BMI, of 30 or greater (obese), or 27 or greater (overweight) in the presence of at least one weight-related comorbidity, such as hypertension, type 2 diabetes mellitus or high cholesterol (dyslipidemia). Qsymia incorporates low doses of active ingredients from two previously approved drugs, phentermine and topiramate. Although the exact mechanism of action is not known, Qsymia is believed to target appetite and satiety, or the feeling of being full, the two main mechanisms that impact eating behavior. Company announced the U.S. market availability of Qsymia for obesity in September 2012. On February 21, 2013, the CHMP confirmed its October 18, 2012 decision to deny the MAA for Qsiva™ (phentermine/topiramate ER) for the treatment of obesity in the European Union, or EU. Company has completed Phase 2 clinical studies for Qsymia for the treatment of sleep apnea and Qsymia for the treatment of type 2 diabetes.

VIVUS's drug, STENDRA, or avanafil, was approved by the FDA for the treatment of erectile dysfunction, or ED, in the U.S. VIVUS, through collaboration arrangements with third parties, intend to market and sell STENDRA in the U.S. and, if approved, under the trade name

SPEDRA™ in the EU and other territories outside the U.S.

Weight Loss Market Analysis:

According to data from the World Health Organization globally there are roughly 1.4 billion people classified as overweight. "By 2030, 50-60% of the populations in many countries are on target to be classified as obese," from a recent report from Bank of America. Further, the obesity drug market in U.S. France, Germany, Italy, Spain, the United Kingdom and Japan is projected to increase to $2.6 billion by 2020. There is no doubt there is a market for weight loss drugs, the question however is Qsymia the drug that will be able to take sufficient market share to justify its current $1 billion capitalization? I question the amount of market share Vivus can obtain and feel there will be a delay in how long it takes to achieve peak penetration. Sell side analysts are projecting that Qsymia can achieve around $1.2 billion in revenue by 2020, this is 46% of projected market. I am forecasting $800 million by 2020, much lower peak market share

Current FDA Approved Competition:

-ALLI (orlistat): Works by preventing digestion of 25% of fat consume. A starter pack of Alli - which includes a month's supply of pills, a dietary guidelines guide, a calorie and fat counter, and a food journal - costs about $54. In the US first quarter 2013 sales of Alli grew 7%, due in part to its restocking

-BELVIQ (Locraserin HCI): BELVIQ is the first FDA-approved weight-loss medicine that works by targeting a hunger receptor in the brain and is believed to help you control portions. The precise way BELVIQ produces feelings of satisfaction is not fully understood, but it is believed to help you lose weight by making you feel satisfied when eating less. BELVIQ is marketed by Arena Pharmaceuticals

Competitors in Pipeline (Currently Conducting Trials):

-Empatic and Contrave from Orexigen. Lead combination product candidates target obesity. Products are Contrave®, which has completed Phase III clinical trials for which a New Drug Application, or NDA, has been submitted and reviewed by the U.S. Food and Drug Administration, or FDA, and Empatic™, which has completed Phase II clinical trials.

-Zafgen: Pipeline is shown below

Source: Zafgen Investor Website

Is Qsymia a drug that will take $1.2 billion dollars in market share by 2020?

For further insight, look at Vivus's 10-Q risk factors:

Qsymia is a combination of two active ingredient drug products approved individually by the FDA that are commercially available and marketed by other companies, although the specific dose strengths and formulation (extended-release vs. immediate-release) would differ. As a result, Qsymia may be subject to substitution by prescribing physicians with individual drugs contained in the Qsymia formulation, which would adversely affect our business.

In the third quarter of 2013, Supernus Pharmaceuticals, Inc. announced its plan to launch Trokendi XR, an extended-release pediatric formulation of the generic drug topiramate that is indicated for pediatric epilepsy. Topiramate is not approved forobesity treatment, and phentermine is only approved for short-term treatment of obesity. However, because the price of Qsymia is significantly higher than the prices of the individual components as marketed by other companies, physicians may have a greater incentive to write prescriptions for the individual components outside of their approved indication, instead of for their combination drug, and this may limit how Vivus prices or market Qsymia.

Patent Protection is Key to maintaining market share for a biotechnology company and Vivus's protection appears to be weak given it is based on two already FDA approved drugs

How is the commercial launch proceeding for Qsymia?

VVUS reported 81,000 TRx for the 2nd quarter. This was very slow growth from the end of the first quarter with 23,000 TRx. The retail launch does not appear to be moving as quickly as the market anticipated

CFO Selling is A Red Flag:

Seth Fischer, the company's CFO, recently sold his shares near time all time company low. The CFO of a biotechnology company is usually the one most attune to the market prices and when might be an opportune to sell. The sale price per the form 4, ranged from $11.90 to $11.95 per share. I see this as a major lack of confidence in the company, and I know he still holds stock in the name, but to sell at a time the stock is burning is not a great sign of confidence from those who know company best

Decision Tree:

Downside (30%): Short Squeeze occurs goes up to $14 per share and shorts should cover

Base Case (35%): $9 price

Upside Case (35%): $6 price target

How Shorts Get Burned:

- Major big pharma marketing partnership announced(unlikely given weak prescription adoption as of now)

- Stronger TRx numbers

- Sale of company(unlikely for same reason above)

- Erectile dysfunction drug becomes meaningful revenue for company

Discounted Cash Flow Analysis:

From my discounted cash flow analysis with a 10% discount rate and no terminal value, I arrive at a $6 price target driven primarily by lower revenue projections than the street.

Street Versus Hunter

Disclosure: I have no positions in any stocks mentioned, but may initiate a short position in VVUS over the next 72 hours. I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it (other than from Seeking Alpha). I have no business relationship with any company whose stock is mentioned in this article. (More...)


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Vivus Will Try Again In Europe With Anti-Obesity Drug

Vivus (VVUS) announced today that it is making a third attempt at gaining European approval for the anti-obesity drug Qsymia (known as Qsiva in Europe). Vivus has submitted to the European Medicines Agency (EMA) a request for scientific advice regarding use of a pre-specified interim analysis from the AQCLAIM cardiovascular outcomes trial (CVOT) to support the resubmission of the marketing authorization application (MAA) for approval.

"Our plan is on track to maximize the value of Qsiva in Europe and we believe that leveraging the AQCLAIM CVOT data is a prudent and scientifically sound approach, guided by our European senior advisors," said Seth Fischer, CEO of VIVUS. "We look forward to working with the European authorities to bring Qsiva to patients suffering from obesity and related comorbidities."

The AQCLAIM study is a randomized, double-blind, placebo-controlled multicenter clinical trial designed to assess the long-term treatment effect of Qsymia on the incidence of major adverse cardiovascular events in overweight and obese subjects with confirmed cardiovascular disease. This study is among the postmarketing requirements determined by the FDA in conjunction with the approval of Qsymia.

Essentially, the stance in Europe has been one that seems to try to mitigate risk as compared to the benefits offered. With minimal data on long-term impacts and effects, the EMA seems to have had a more cautious stance to anti-obesity medicines than the United States. Even Arena Pharmaceuticals (ARNA) Belviq has come across the more conservative stance of the EMA. Arena withdrew its application rather than face a rejection due to major concerns outlined by the agency. Another competitor, Orexigen (OREX), is in the application process with the anti-obesity drug Contrave.

Vivus is anticipating enrolling patients in the Aqclaim study in the next 6 months. The request for scientific advice from the EMA may allow the study to incorporate, and thus cover, the concerns of the European agency. In theory, this could pave the way to at least increasing the chance of an eventual approval.

In my opinion, the company with the fastest chance of European approval is Orexigen and Contrave. In fact, Contrave may have a faster path in Europe than it does in the United States. Vivus appears to be trying, and Arena seems to have placed Europe on a back burner of sorts.

For investors this news may seem welcomed, but it is really the first time we have heard anything material from the new CEO that took over only a month after Tony Zook resigned due to health issues. This European news is more long term for Vivus than near term. In the near term we once again have pretty flat sales growth for Qsymia in the United States. This past week sales, according to IMS Health, were just under 10,200. This points to about 9 consecutive weeks of essentially treading water on the sales figures. What is needed is stronger sales growth. Stalling at about 10,000 does not help illustrate longer term potential.

Disclosure: I am long ARNA. I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it (other than from Seeking Alpha). I have no business relationship with any company whose stock is mentioned in this article. (More...)

Additional disclosure: I have no position in Vivus or Orexigen


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Monday, 9 September 2013

Vivus' Qsymia Scripts Remain Flat

The Vivus (VVUS) anti-obesity drug Qsymia is still essentially seeing flat sales for the third week in a row. This is happening as a new CEO takes over after former CEO Tony Zook stepped down only a month into that role after a long proxy fight.

Vivus saw great traction in prescription numbers when the company was able to add certified pharmacies to its distribution, but the influx of new channels for selling the drug, as I anticipated, leveled off. What we seem to have now is Vivus stuck in the 10,000 scripts per week range. I am anticipating that next week will be flat yet again.

(click to enlarge)Qsymia Prescription Sales

On an unadjusted basis Vivus has seen about 203,000 prescriptions sold in 51 weeks. This number is well short of what was expected from an anti-obesity drug with a potential market of over 100,000 Americans. Even with a 30% upward adjustment we are seeing sales at a modest 264,000. If next week does indeed remain flat the 1 year adjusted prescription sales figure will be right around 277,000. At about $60 per script in net sales, the revenue story only approaches about $16.5 million, well short of the type of cash needed to continue operations and pay for FDA required studies.

What will it take to see sales increase? Insurance coverage, advertising, and consumer acceptance. Competitor Arena (ARNA) has Belviq on the market, and other entrants such as Orexigen (OREX) are waiting in the wings. Vivus had the advantage of being first to market, but the market has not yet been robust enough to show the blockbuster promise that was once assigned to it.

Generic phentermine sells between 130,000 and 150,000 scripts per week. This is the market that both Vivus and Arena are trying to tap into. Thus far these companies have managed to garner just a modest share despite Qsymia being on the market for nearly a year and Belviq being on the market for 3 months.

For investors to question the slow growth in sales is a natural reaction. The bigger issue is what the company mission will be. With Tony Zook stepping down and a new CEO taking the reins, investors need to know whether or not the strategies outlined by Zook are still intact.

Modest sales of Qsymia make the Stendra pipeline more important than ever. Vivus was able to partner with Stendra in Europe and received a cash infusion, but there is still clearly a need to see sales of Qsymia or Stendra begin to hit the desired marks. As yet the inaction is dragging the potential of the sector down. Stay Tuned.

Disclosure: I am long ARNA. I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it (other than from Seeking Alpha). I have no business relationship with any company whose stock is mentioned in this article. (More...)

Additional disclosure: I have no position in Vivus or Orexigen.


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Wednesday, 4 September 2013

More Shakeups At Vivus: CEO Resigns

The shake-up and uncertainty at Vivus (VVUS) continues with the sudden announcement that the brand new CEO of the company has resigned just a month into his new position.

Anthony P. Zook had taken on the role of CEO when activist shareholder First Manhattan won a prolonged proxy battle to take control of the company. Zook was heralded by First Manhattan as a great fit for the company, whose big pharma experience could drive the company forward as it re-launched the anti-obesity drug Qsymia. Zook's resignation is effective September 3, 2013, and is reportedly due to recurring issues associated with a previously-diagnosed medical condition.

The Vivus Board of Directors has appointed Seth H. Z. Fischer, a former senior executive at Johnson & Johnson, to serve as its Chief Executive Officer, effective today. Mr. Fischer will also join the VIVUS Board of Directors.

Seth H. Z. Fischer has three decades of healthcare experience in the pharmaceutical and medical device industry. Mr. Fischer served in positions of increasing responsibility with Johnson & Johnson until his retirement in 2012. Most recently, Mr. Fischer served as Company Group Chairman Johnson & Johnson and Worldwide Franchise Chairman, Cordis Corporation from 2008 to 2012, and as Company Group Chairman, North America Pharmaceuticals from 2004 to 2007, which included responsibilities for Ortho-McNeil Pharmaceuticals, Janssen and Scios. Prior to this position, Mr. Fischer served as President of Ortho-McNeil Pharmaceuticals from 2000 to 2004. His operating responsibilities encompassed the commercialization of products in multiple therapeutic categories including Topamax(R) for epilepsy and migraine, and products in the analgesic, anti-infective, cardiovascular, neurologic, psychiatric and women's health areas. He is currently a member of the Board of Directors of Trius Therapeutics, Inc. and BioSig Technologies, Inc, and an advisor to MedHab, LLC.

For investors there is a lot to consider. A company that was already facing serious headwinds offered up several "golden parachutes" to outgoing management and lucrative employment deals to the incoming players. Now the executive deal making has yet another chapter.

Much of the hope and valuation of Vivus is pinned to the anti-obesity drug Qsymia. Sales have been modest thus far and competitors are entering the space. Arena (ARNA) has its drug, Belviq, already on the market and Orexigen (OREX) has its drug, Contrave, working its way through approvals. Arena's Belviq has seen a more successful launch than Qsymia, but with a lack of insurance participation, sales of both drugs have not reached levels that say "blockbuster".

Under Zook, Vivus was slated to increase sales of Qsymia, find a big pharma partner for the drug, and pursue getting the drug approved in Europe. Qsymia was rejected previously in Europe, and while Vivus did enjoy first to market status in the U.S., it squandered that opportunity. As things stand now it appears that Contrave may have the best shot at being first to market in Europe.

Vivus had "bought" some time for itself with the management and board shake-up, but patience of investors may wear thin with yet another change. The street is looking for performance and numbers, not promises and hope. The "potential" story can only last so long. Last week Qsymia sold about 10,000 prescriptions. It will take a lot more than that to instill investor confidence. Stay tuned.

Disclosure: I am long ARNA. I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it (other than from Seeking Alpha). I have no business relationship with any company whose stock is mentioned in this article. (More...)

Additional disclosure: I have no position in Orexigen or Vivus


View the original article here