Showing posts with label concerns. Show all posts
Showing posts with label concerns. Show all posts

Monday, 9 September 2013

Expectations For Eli Lilly's Lung Cancer Drug Rise, But Revenue Concerns Continue

Eli Lilly & Co. (LLY): Expectations For Eli Lilly's Lung Cancer Drug Rise, But Revenue Concerns Continue - Seeking Alpha (function(_,e,rr,s){_errs=[s];var c=_.onerror;_.onerror=function(){var a=arguments;_errs.push(a); c&&c.apply(this,a)};var b=function(){var c=e.createElement(rr),b=e.getElementsByTagName(rr)[0]; c.src="//beacon.errorception.com/"+s+".js";c.async=!0;b.parentNode.insertBefore(c,b)}; _.addEventListener?_.addEventListener("load",b,!1):_.attachEvent("onload",b)}) (window,document,"script","4ffae9d6f05d1da630000008"); if (SA.Data && SA.Data.Cache) { var adata = SA.Data.Cache.get('campaign_content'); }.market_currents_list li .ticker_date_left .mc_list_tickers a{font-weight: normal} var ms_slug = ''; var article_dashboards = '@investing-ideas@sectors@'; var article_sectors_themes = '@long-ideas@us@drug-manufacturers-major@healthcare@article@'; var ratings_hash={}; var ARTICLE_ID = 1667152; var ARTICLE_TYPE = "standard"; var ARTICLE_LOCK = ""; var author_slug = "a-john-hodge"; var pticker_for_ads = "lly"; var time_left; var lock_comments = false; var machine_cookie = readCookie('machine_cookie'); var middle_version = ABTest.identity%10; try { window.sessionStorage.setItem("/article/"+ARTICLE_ID, '1'); } catch (error) {}var mone_article_tags = "{bmy,mrk,lly};;;{healthcare};;;{long-ideas,us,drug-manufacturers-major,investing-ideas};;;{a-john-hodge}"var ord = Math.floor(Math.random()*1000000000);Seeking Alpha Seeking Alpha Portfolio App for iPad Finance (1) var ipadData; SeekingAlpha.Initializer.AddAfterLoad(function(){ if (SA.Utils.Env.isIPad && !/3/.test(SA.Data.Cookies.get("user_devices"))){ Mone.event("ipad_promotion_top","top_ipad_banner_large","ipad_promotion_displayed"); ipadData = new SA.Data.iPad(); ipadData.instanceName = "ipadData"; var responseHandler = new Object(); responseHandler.handleResponse = function(data){ if (!data.averageUserRating) return; var stars = data.averageUserRating Home | Portfolio | Market Currents | Investing Ideas | Dividends & Income | ETFs | Macro View | ALERTS | PRO   This article was sent to 7,235 people who get email alerts on  . Which cover: new articles | breaking news | earnings results | dividend announcements Get email alerts on   » This article was sent to 337,618 people who get the Investing Ideas newsletter. Get the Investing Ideas newsletter » Expectations For Eli Lilly's Lung Cancer Drug Rise, But Revenue Concerns Continue Aug 30 2013, 15:47 by: A John Hodge  |  about: LLY, includes: BMY, MRK BOOKMARKED / READ LATER Bookmarked

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Eli Lilly Co. (LLY), in desperate need of a blockbuster new drug, may have struck gold when its lung cancer drug, necitumumab (IMC-11F8), was shown to extend patient survival in a phase 3 study. Necitumumab has met its primary endpoint in improving overall survival in patients who received the drug in combination with gemcitabine and cisplatin as a first-line therapy for metastatic squamous non-small cell lung cancer (NSCLC) when compared with chemotherapy alone. Necitumumab is a fully human IgG1 monoclonal antibody designed to block the ligand binding site of the human epidermal growth factor receptor (EGFR), which is a target in several anti-cancer treatments because it sparks cancer progression, both by promoting angiogenesis, or the formation of new blood vessels for tumors, and by inhibiting apoptosis, or cell death.

Necitumumab: From The Ash Heap To Blockbuster Drug?

Lilly expects to submit necitumumab for approval to the Food and Drug Administration (FDA) by the end of the year and, if approved, it could be a great revenue source for the company. Globally, the non-small-cell lung cancer (NSCLC) drug market is expected to reach $6.9 billion in 2019 and climb to $7.9 billion in 2022. There are over 1.2 million new cases of lung cancer diagnosed every year and over 1 million lung cancer patients will die each year, and non-small cell lung cancer (NSCLC) accounts for approximately 80% of all lung cancers. The positive results from the drug came as a surprise according to Mark Schoenebaum, analyst with ISI Group LLC, since not so long ago analysts had given up on necitumumab, with "basically zero" expectations as the drug failed in a prior non-squamous lung cancer trial. Bristol Myers Squibb (BMY), Lilly's partner in the drug, even gave it up as the company terminated the collaboration in late 2012. Mr. Schoenebaum added however, "We really need to see the full data to understand risk/benefit."

While necitumumab could be a potent boost to Lilly's product portfolio, the drug could also bring a much-needed new therapy for NSCLC, a cancer that has been proven difficult to treat with the current drugs on the market, such as Genentech's Avastin, which directly target tumors, as opposed to more broadly active chemotherapy drugs. Richard Gaynor, vice president of product development and medical affairs for Lilly Oncology, said in a prepared statement, "If approved, necitumumab could be the first biologic therapy indicated to treat patients with squamous lung cancer." And it is quite conceivable that the drug will dominate the NSCLC market with sales expected to reach $1.75 billion by 2022.

But necitumumab is not without some possible stiff competition, as Merck (MRK) plans to initiate late-stage clinical trials of lambrolizumab in the third quarter of 2013 for both non-small cell lung cancer and advanced melanoma. Lambrolizumab, which received "breakthrough status" in late April by the FDA, is an investigational antibody therapy designed to disrupt the action of the immune checkpoint protein PD-1 and therefore inhibit the ability of some cancers to evade the body's immune system.

Generics Continue To Chip Away At Revenue

Eli Lilly will be in need of new successful drugs to market, as sales of its $4.99 billion blockbuster treatment to combat depression, Cymbalta, are expected to plummet when the company loses U.S. patent protection in December. Cymbalta accounted for 22% of the $22 billion in global product sales in 2012, and $1.5 billion in second quarter of 2013. When a blockbuster drug falls off patent it can be devastating to revenue, as witnessed with Zyprexa, Lilly's once best-selling schizophrenia treatment, which had $2.17 billion in domestic sales the year before its patent expired. However, after the drug came off patent the company sold a mere $360 million in the U.S. as 63% of its sales were gobbled up by generic competition. And Lilly will experience more revenue declines as some of the company's other drugs fall off patent, like its $2.4 billion mealtime insulin, Humalog, which expires in June 2014. And the company will also lose its $1 billion osteoporosis medication, Evista, which falls off patent in March of 2014.

Solid Pipeline May Bring Solid Revenues Down The Line

The future is not glum for Lilly, as the company has spent heavily on R&D over the past few years, with $5.28 billion on R&D in 2012, and has no less than 60 potential new drugs in testing, including three in regulatory review and ten in phase 3 trials. For example Lilly submitted empagliflozin for a new drug application (NDA) for the treatment of type 2 diabetes in adults. Empagliflozin is one of a new class of glucose-lowering drugs which work by increasing urinary glucose excretion with a consequent lowering of plasma glucose levels. The company expects to receive a decision by the end of the second quarter 2014.

Lilly's advanced gastric cancer drug, ramucirumab, showed promising results from its phase 3 trials as the drug showed the median overall survival was better in 238 patients who received ramucirumab than in the 117 patients who received placebo. Earlier this year, the company initiated a fast track review to the FDA. Lilly also submitted the drug for approval for breast cancer patients, which could be where the real revenue success for the drug would be found. According to a recent CitiGroup report, peak sales potential could exceed $3 billion.

Cost Cutting: A Leaner Lilly In The Works

Ely Lilly's management team feels confident that over the next few years it will be able to mitigate the negative revenue impact of its drugs' patent expirations with successful launches of its late stage portfolio. The company is also mitigating its lost revenue with a series of cost cuts by slashing jobs and raising prices on Cymbalta before the patent expires. And these cuts have helped as Lilly's second-quarter earnings are up with reported earnings of $1.21 billion while worldwide revenues rose 6% to $5.93 billion, beating Wall Street expectations of $5.82 billion. Lilly also raised its EPS guidance for the year, to earn between $4.28 and $4.38 per share for the year on revenues between $22.6 billion and $23.4 billion.

The cost cutting will continue according to Lilly's Senior Director of Global Corporate Communications Ed Sagebiel, "We continue to face the most significant challenges in our history." The company will suspend base pay increases for most of its employees next year till 2015. Plus the company will be reducing bonuses by 25% for 2014, and it won't be paid out till 2015. These cuts are expected to shave $400 million through 2016. In May the company announced that roughly 1,000 sales staffers would be laid off, which amounted to 40% of the U.S. salesforce.

Ely Lilly is a $50.09 billion market cap company. Year-over-year the stock is up just under 20%, however the stock's growth has slowed from its late April high of $58.40. The company still has a solid dividend with a yield of 3.74, and carries one of the lower P/E ratios of the major drug companies, at 11.67. And the company holds more than $4.6 billion in short-term liquidity.

Conclusion

Big Pharma is experiencing a glut of generics eating away at what were once their revenue cash cows. However there seems to be new cash cows working their way down the pipelines. Lilly too has been hit hard and will continue to be hit hard by the generics, though the company has done some much needed "belt tightening" to get it through the tough times. And CEO John Lechleiter is quite confident that these measures will get them through, as he commented in a prepared statement: "Continued operating and financial discipline, along with a maturing pipeline of potential new medicines, gives me great confidence in the company's ability to meet the challenges we face from upcoming patent expirations and to resume growth after 2014."

While Lilly may experience a rocky road for the next few quarters, for an excellent dividend stock and a patient investor, Eli Lilly, with its cost cutting measures and perhaps a few blockbuster drugs in the pipeline, should be a good long-term stock to have in one's portfolio.

Source: Expectations For Eli Lilly's Lung Cancer Drug Rise, But Revenue Concerns Continue

Disclosure: I have no positions in any stocks mentioned, and no plans to initiate any positions within the next 72 hours. I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it. I have no business relationship with any company whose stock is mentioned in this article. (More...)

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Wednesday, 4 September 2013

Safety Concerns May Prevent FDA Approval Of Ligand's Drug Aprela

By October 3, 2013, the U.S. Food and Drug Administration (FDA) will decide whether to approve Ligand Pharmaceutical's (LGND) drug Aprela for the treatment of menopausal symptoms and the prevention of postmenopausal osteoporosis in non-hysterectomized women. This drug is being developed by Ligand in partnership with Pfizer (PFE). After reviewing Aprela's clinical trial results and relevant scientific literature, we believe Aprela will fail to receive FDA approval and, consequently, Ligand's stock will underperform in the near term.

Background

Ligand Pharmaceutical is a small biotechnology company with a focus on acquiring and developing drugs that will generate royalty revenue. Aprela, its current lead product, has been developed for the treatment of menopause.

Menopause is the cessation of menstruation. It is a biological process that occurs naturally among women but can also arise from surgical interventions that affect ovary function. The main menopausal symptoms include hot flashes, night sweats, sleep disturbances, vaginal dryness, and vulvar and vaginal atrophy. Hot flashes are the most common type of symptom associated with menopause. In addition, menopause is also a major risk factor for osteoporosis.

Hormone therapy (HT) is the only FDA-approved treatment for menopause. However, the FDA recently approved a non-hormonal therapy named Brisdelle for menopausal hot flashes. HT was considered the gold standard among treatment options until 2002 when a study published by the Women's Health Initiative suggested that HT might increase the risk of breast cancer, venous thromboembolism, and stroke. As a result, the number of women taking HT precipitously dropped.

Aprela combines conjugated estrogens (CE) with bazedoxifene (BZA), a selective estrogen receptor modulator. Estrogens have established efficacy in relieving menopausal symptoms and postmenopausal osteoporosis, while BZA has demonstrated protective effects on the uterus and breast. BZA has been approved in Europe and Japan for the treatment of postmenopausal osteoporosis.

BZA/CE improves menopausal symptoms, but less effectively than standard HT

The efficacy and safety of BZA/CE have been evaluated in multicenter, randomized, double-blind, placebo- and active-controlled, phase III studies referred to as the SMART trials. In total, there are five SMART trials. SMART-1 evaluated the endometrial safety of six BZA/CE doses. Two doses (BZA at 20mg and CE at 0.45 or 0.625 mg) were selected for subsequent trials.

The efficacy of BZA/CE for vasomotor symptoms was evaluated in the SMART-2 trial in 332 symptomatic women. At week 12, treatment with BZA/CE at both doses significantly reduced the number of hot flashes by 74% (10.3 hot flashes at baseline vs. 2.8 at week 12) and 80% (10.4 vs. 2.4), respectively, versus 51% (10.5 vs. 5.4) with placebo. The mean daily hot flush severity was also significantly reduced for both BZA/CE doses compared with placebo at week 12. However, based on results from the Women's Hope study, HT reduced the number of hot flashes from baseline by over 90% and the improvement with mean daily hot flush severity was also greater compared with the two BZA/CE doses.

The efficacy of BZA/CE for vulvar/vaginal atrophy was evaluated using four measures in the SMART-3 trial in 664 postmenopausal women. BZA/CE was shown to be effective at treating these vaginal symptoms compared with placebo or BZA alone.

The efficacy of BZA/CE for osteoporosis prevention was evaluated using bone mineral density (BMD) measures in SMART-4 and SMART-5, and two sub-studies within the SMART-1 trial. In the SMART-1 trial, BZA/CE at both doses significantly increased lumbar spine and total hip BMD compared with placebo at 2 years. Similar phenomenon was observed in the SMART-4 and -5 trials. In SMART-4, however, the increases of BZA/CE on spine BMD (~0.80% increase from baseline) were significantly lower than those observed for HT (~2.22% increase from baseline). In SMART-5, the increases of BZA/CE on spine BMD were also lower than those observed for HT. Although both BZA/CE and HT could effectively increase BMD compared to placebo, HT consistently shows a better efficacy profile with regard to BMD.

BZA/CE trials could not determine long-term safety

The safety of BZA/CE was evaluated against HT or placebo in the SMART-1, -4 and -5 trials. SMART-1, -4, and -5 evaluated endometrial safety as indicated by the incidence of endometrial hyperplasia. Endometrial hyperplasia is excessive growth of cells lining the endometrium or uterus and poses a risk factor for the development of endometrial cancer. At year one, the incidence of endometrial hyperplasia with BZA/CE was similar to that in the placebo group in the SMART-1 and SMART-5 trials. At year one of SMART-4 trial, no cases of endometrial hyperplasia were identified in the BZA 20-mg/CE 0.45-mg group, the CE group, or the placebo group. However, three cases (1.1%) were confirmed for the BZA 20-mg/CE 0.625-mg group. One explanation for this is the difference in the administered BZA/CE formulations. The bioavailability of BZA in the formulation was 18% lower than the formulation used previously, resulting in insufficient level of BZA to maintain endometrial safety. Such formulation and stability issues could serve as a hurdle in the FDA approval process.

High breast density is a risk factor for developing breast cancer. In the SMART-1 trial, BZA/CE demonstrated non-inferiority versus placebo while HT showed a significant increase in mean percent breast density at one year, suggesting a potential advantage of BZA/CE over HT. There was a higher incidence of AEs leading to study discontinuation in the HT group due to metorrhagia, uterine hemorrhage, and vaginal hemorrhage.

For a one-year period, BZA/CE did seem to have a favorable safety/tolerability profile. The overall incidence of adverse events was similar among treatment groups. However, these studies could not properly evaluate longer-term safety effects of BZA/CE. Specifically, the studies did not evaluate AEs such as cancers that occur relatively infrequently. Notably, this cancer risk is a primary concern with HT. Thus, despite having compromised efficacy, BZA/CE may not have better long-term safety than standard HT.

The FDA has set a high safety bar for alternative therapy to treat menopause

Previously, the FDA delayed approval of BZA for the treatment of postmenopausal osteoporosis because of concerns about the incidence of stroke and blood clotting. In particular, the agency required additional analysis of the incidence of stroke and venous thrombotic events, raising doubt about the BZA/CE combination therapy quickly gaining approval.

Recently, the FDA approved the first non-hormonal therapy, Brisdelle, for the treatment of hot flashes. The approval was considered somewhat surprising given the poor efficacy of Brisdelle compared to HT. Overall, this suggests that the FDA prioritizes safety over efficacy in menopausal therapeutics, which further decreases the likelihood of Aprela being approved. In addition, Pfizer previously sought an extended label for its drug Pristiq to cover hot flashes, but received a complete response letter requesting additional studies on the safety of the drug. Generally, the FDA has set a high bar for safety of alternative menopausal therapy and, in our opinion, Aprela does not clear this bar.

A solid business model and extensive pipeline may overcome any short-term setbacks

In early August, many analysts downgraded Ligand's stock. This was likely due to a combination of a run-up in price and a halt in the development of two drug candidates being developed in partnership with The Medicines Company (MDCO) and Merck (MRK). This news came on the heels of the company's second quarter earnings report, which shows revenue up by 67% and royalty payments up by 63% over the previous quarter. The company has also doubled it shareholder's equity from one year ago and is currently generating a positive cash flow. With 85 drugs in its pipeline and the potential to double its royalty-generating assets over the next few years, Ligand can tolerate a few setbacks. Thus, we see Ligand stock as a promising long-term investment, but one to avoid through the beginning of October.

Summary

Ligand's Aprela improves menopausal symptoms and postmenopausal osteoporosis simultaneously, although its efficacy seems to be not as good as that for HT. Regarding safety, currently available data do not provide sufficient evidence that Aprela has a better long-term safety profile than HT. We believe that the FDA will likely continue applying stringent safety criteria to potential menopause drugs, leading us to conclude that Aprela is unlikely to obtain FDA approval. Nevertheless, the company's business model and extensive drug pipeline has gained considerable positive attention from investors, which we believe is well deserved.

Disclosure: I have no positions in any stocks mentioned, and no plans to initiate any positions within the next 72 hours. (More...)

Business relationship disclosure: Beacon VP Investments is a team of analysts. This article was written by Dr. Hyun Ji Noh and Sophie Wang, two of our team members. We are not receiving compensation for the article (other than from Seeking Alpha). We have no business relationship with any company whose stock is mentioned in this article.


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Monday, 2 September 2013

Expectations For Eli Lilly's Lung Cancer Drug Rise, But Revenue Concerns Continue

Eli Lilly & Co. (LLY): Expectations For Eli Lilly's Lung Cancer Drug Rise, But Revenue Concerns Continue - Seeking Alpha (function(_,e,rr,s){_errs=[s];var c=_.onerror;_.onerror=function(){var a=arguments;_errs.push(a); c&&c.apply(this,a)};var b=function(){var c=e.createElement(rr),b=e.getElementsByTagName(rr)[0]; c.src="//beacon.errorception.com/"+s+".js";c.async=!0;b.parentNode.insertBefore(c,b)}; _.addEventListener?_.addEventListener("load",b,!1):_.attachEvent("onload",b)}) (window,document,"script","4ffae9d6f05d1da630000008"); if (SA.Data && SA.Data.Cache) { var adata = SA.Data.Cache.get('campaign_content'); }.market_currents_list li .ticker_date_left .mc_list_tickers a{font-weight: normal} var ms_slug = ''; var article_dashboards = '@investing-ideas@sectors@'; var article_sectors_themes = '@long-ideas@us@drug-manufacturers-major@healthcare@article@'; var ratings_hash={}; var ARTICLE_ID = 1667152; var ARTICLE_TYPE = "standard"; var ARTICLE_LOCK = ""; var author_slug = "a-john-hodge"; var pticker_for_ads = "lly"; var time_left; var lock_comments = false; var machine_cookie = readCookie('machine_cookie'); var middle_version = ABTest.identity%10; try { window.sessionStorage.setItem("/article/"+ARTICLE_ID, '1'); } catch (error) {}var mone_article_tags = "{bmy,mrk,lly};;;{healthcare};;;{long-ideas,us,drug-manufacturers-major,investing-ideas};;;{a-john-hodge}"var ord = Math.floor(Math.random()*1000000000);Seeking Alpha Seeking Alpha Portfolio App for iPad Finance (1) var ipadData; SeekingAlpha.Initializer.AddAfterLoad(function(){ if (SA.Utils.Env.isIPad && !/3/.test(SA.Data.Cookies.get("user_devices"))){ Mone.event("ipad_promotion_top","top_ipad_banner_large","ipad_promotion_displayed"); ipadData = new SA.Data.iPad(); ipadData.instanceName = "ipadData"; var responseHandler = new Object(); responseHandler.handleResponse = function(data){ if (!data.averageUserRating) return; var stars = data.averageUserRating Home | Portfolio | Market Currents | Investing Ideas | Dividends & Income | ETFs | Macro View | ALERTS | PRO   This article was sent to 7,224 people who get email alerts on  . Which cover: new articles | breaking news | earnings results | dividend announcements Get email alerts on   » This article was sent to 337,202 people who get the Investing Ideas newsletter. Get the Investing Ideas newsletter » Expectations For Eli Lilly's Lung Cancer Drug Rise, But Revenue Concerns Continue Aug 30 2013, 15:47 by: A John Hodge  |  about: LLY, includes: BMY, MRK BOOKMARKED / READ LATER Bookmarked

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Eli Lilly Co. (LLY), in desperate need of a blockbuster new drug, may have struck gold when its lung cancer drug, necitumumab (IMC-11F8), was shown to extend patient survival in a phase 3 study. Necitumumab has met its primary endpoint in improving overall survival in patients who received the drug in combination with gemcitabine and cisplatin as a first-line therapy for metastatic squamous non-small cell lung cancer (NSCLC) when compared with chemotherapy alone. Necitumumab is a fully human IgG1 monoclonal antibody designed to block the ligand binding site of the human epidermal growth factor receptor (EGFR), which is a target in several anti-cancer treatments because it sparks cancer progression, both by promoting angiogenesis, or the formation of new blood vessels for tumors, and by inhibiting apoptosis, or cell death.

Necitumumab: From The Ash Heap To Blockbuster Drug?

Lilly expects to submit necitumumab for approval to the Food and Drug Administration (FDA) by the end of the year and, if approved, it could be a great revenue source for the company. Globally, the non-small-cell lung cancer (NSCLC) drug market is expected to reach $6.9 billion in 2019 and climb to $7.9 billion in 2022. There are over 1.2 million new cases of lung cancer diagnosed every year and over 1 million lung cancer patients will die each year, and non-small cell lung cancer (NSCLC) accounts for approximately 80% of all lung cancers. The positive results from the drug came as a surprise according to Mark Schoenebaum, analyst with ISI Group LLC, since not so long ago analysts had given up on necitumumab, with "basically zero" expectations as the drug failed in a prior non-squamous lung cancer trial. Bristol Myers Squibb (BMY), Lilly's partner in the drug, even gave it up as the company terminated the collaboration in late 2012. Mr. Schoenebaum added however, "We really need to see the full data to understand risk/benefit."

While necitumumab could be a potent boost to Lilly's product portfolio, the drug could also bring a much-needed new therapy for NSCLC, a cancer that has been proven difficult to treat with the current drugs on the market, such as Genentech's Avastin, which directly target tumors, as opposed to more broadly active chemotherapy drugs. Richard Gaynor, vice president of product development and medical affairs for Lilly Oncology, said in a prepared statement, "If approved, necitumumab could be the first biologic therapy indicated to treat patients with squamous lung cancer." And it is quite conceivable that the drug will dominate the NSCLC market with sales expected to reach $1.75 billion by 2022.

But necitumumab is not without some possible stiff competition, as Merck (MRK) plans to initiate late-stage clinical trials of lambrolizumab in the third quarter of 2013 for both non-small cell lung cancer and advanced melanoma. Lambrolizumab, which received "breakthrough status" in late April by the FDA, is an investigational antibody therapy designed to disrupt the action of the immune checkpoint protein PD-1 and therefore inhibit the ability of some cancers to evade the body's immune system.

Generics Continue To Chip Away At Revenue

Eli Lilly will be in need of new successful drugs to market, as sales of its $4.99 billion blockbuster treatment to combat depression, Cymbalta, are expected to plummet when the company loses U.S. patent protection in December. Cymbalta accounted for 22% of the $22 billion in global product sales in 2012, and $1.5 billion in second quarter of 2013. When a blockbuster drug falls off patent it can be devastating to revenue, as witnessed with Zyprexa, Lilly's once best-selling schizophrenia treatment, which had $2.17 billion in domestic sales the year before its patent expired. However, after the drug came off patent the company sold a mere $360 million in the U.S. as 63% of its sales were gobbled up by generic competition. And Lilly will experience more revenue declines as some of the company's other drugs fall off patent, like its $2.4 billion mealtime insulin, Humalog, which expires in June 2014. And the company will also lose its $1 billion osteoporosis medication, Evista, which falls off patent in March of 2014.

Solid Pipeline May Bring Solid Revenues Down The Line

The future is not glum for Lilly, as the company has spent heavily on R&D over the past few years, with $5.28 billion on R&D in 2012, and has no less than 60 potential new drugs in testing, including three in regulatory review and ten in phase 3 trials. For example Lilly submitted empagliflozin for a new drug application (NDA) for the treatment of type 2 diabetes in adults. Empagliflozin is one of a new class of glucose-lowering drugs which work by increasing urinary glucose excretion with a consequent lowering of plasma glucose levels. The company expects to receive a decision by the end of the second quarter 2014.

Lilly's advanced gastric cancer drug, ramucirumab, showed promising results from its phase 3 trials as the drug showed the median overall survival was better in 238 patients who received ramucirumab than in the 117 patients who received placebo. Earlier this year, the company initiated a fast track review to the FDA. Lilly also submitted the drug for approval for breast cancer patients, which could be where the real revenue success for the drug would be found. According to a recent CitiGroup report, peak sales potential could exceed $3 billion.

Cost Cutting: A Leaner Lilly In The Works

Ely Lilly's management team feels confident that over the next few years it will be able to mitigate the negative revenue impact of its drugs' patent expirations with successful launches of its late stage portfolio. The company is also mitigating its lost revenue with a series of cost cuts by slashing jobs and raising prices on Cymbalta before the patent expires. And these cuts have helped as Lilly's second-quarter earnings are up with reported earnings of $1.21 billion while worldwide revenues rose 6% to $5.93 billion, beating Wall Street expectations of $5.82 billion. Lilly also raised its EPS guidance for the year, to earn between $4.28 and $4.38 per share for the year on revenues between $22.6 billion and $23.4 billion.

The cost cutting will continue according to Lilly's Senior Director of Global Corporate Communications Ed Sagebiel, "We continue to face the most significant challenges in our history." The company will suspend base pay increases for most of its employees next year till 2015. Plus the company will be reducing bonuses by 25% for 2014, and it won't be paid out till 2015. These cuts are expected to shave $400 million through 2016. In May the company announced that roughly 1,000 sales staffers would be laid off, which amounted to 40% of the U.S. salesforce.

Ely Lilly is a $50.09 billion market cap company. Year-over-year the stock is up just under 20%, however the stock's growth has slowed from its late April high of $58.40. The company still has a solid dividend with a yield of 3.74, and carries one of the lower P/E ratios of the major drug companies, at 11.67. And the company holds more than $4.6 billion in short-term liquidity.

Conclusion

Big Pharma is experiencing a glut of generics eating away at what were once their revenue cash cows. However there seems to be new cash cows working their way down the pipelines. Lilly too has been hit hard and will continue to be hit hard by the generics, though the company has done some much needed "belt tightening" to get it through the tough times. And CEO John Lechleiter is quite confident that these measures will get them through, as he commented in a prepared statement: "Continued operating and financial discipline, along with a maturing pipeline of potential new medicines, gives me great confidence in the company's ability to meet the challenges we face from upcoming patent expirations and to resume growth after 2014."

While Lilly may experience a rocky road for the next few quarters, for an excellent dividend stock and a patient investor, Eli Lilly, with its cost cutting measures and perhaps a few blockbuster drugs in the pipeline, should be a good long-term stock to have in one's portfolio.

Source: Expectations For Eli Lilly's Lung Cancer Drug Rise, But Revenue Concerns Continue

Disclosure: I have no positions in any stocks mentioned, and no plans to initiate any positions within the next 72 hours. I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it. I have no business relationship with any company whose stock is mentioned in this article. (More...)

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Thursday, 25 July 2013

'The stigma associated with raising concerns has to be removed'

Nurse behind frosted glass Whistleblowing can be a frightening and daunting task and people feel it is easier not to speak out about bad practice. Photograph: Christopher Thomond for the Guardian

The term whistleblower often conjures up anxiety and fear in those wishing to raise concerns. Meanwhile, the response to those brave enough to do so can be defensive and doubting. This is enough to deter someone from coming forward to raise concerns.

I know from my experience at Mid Staffordshire how frightening and daunting a task it is to raise concerns in the workplace. There are many reasons why people feel that it is just easier to turn a blind eye and not raise your head above the parapet. While these reasons are often valid and must not be dismissed, it is vital that where problems exist those who witness them must speak out in order for things to change.

The stigma associated with raising concerns has to be removed. This can be achieved by increasing awareness of how to raise concerns safely and appropriately, so that it becomes not only expected, but also accepted. The option of whether you should act upon your concerns and blow the whistle should not exist. There are two main factors that prevent people raising concerns. Staff do not know enough about the actual process and they fear personal and professional repercussions.

All NHS trusts and organisations should provide standardised policies for raising concerns and deliver training and awareness of the process so that staff feel informed and empowered. It is vital for these trusts and organisations to promote the importance of raising concerns and offer reassurance and positive feedback to those who do. This united message would soon encourage people to raise concerns if they have them. If this is then evidenced by action rather than just words, the historic culture of people failing to speak out, or no effective action being taken if they do, will begin to change.

Those of us working in health and social care have a duty to act as advocates for the people we care for and this sometimes means speaking out when things are not right.

Through my own difficult personal experience I am clear that there is so much more that can be done to raise awareness and support staff who want to raise concerns. In my role as ambassador for cultural change, I hope the situations I faced at Mid Staffordshire, and what I learnt from them, can really help to encourage a more open and transparent culture across the partnership trust.

I want to encourage even greater professionalism, support staff to raise concerns and ensure that the voice of the frontline is heard clearly at a senior level within the organisation. I have a clear remit from partnership trust chief executive Stuart Poynor and the trust board to act freely and with complete autonomy from the management team, as another route for issues of concern to be raised at the highest level. This is essential and will help ensure an open transparent workforce.

My aim is to help empower staff to deliver an excellent service and be an ally for anyone on the frontline who is worried about raising concerns. I wish to hear the voice of those who are delivering care and services. I question:

• How supported do staff feel?
• Are staff confident that they know how to raise concerns?
• Have staff raised concerns in the past? What has been the response?
• Do staff feel listened to?
• What helps and hinders staff from doing their jobs well?
• What do patients/service users and relatives feel? 

I want staff to know that I am here as their support to improve the way we all work and ultimately give the best possible care.

Because of this role and my chief executive's forward thinking, I am optimistic about the future. The only way forward is to extend this type of role to all trusts. Trust boards throughout the NHS should embrace the concept and unite to help change the culture. We have a responsibility to protect and restore confidence in the NHS and, most importantly, protect those who need to use it.

Helene Donnelly is ambassador for cultural change at Staffordshire and Stoke on Trent partnership NHS trust.

This article is published by Guardian Professional. Join the Healthcare Professionals Network to receive regular emails and exclusive offers.


View the original article here

'The stigma associated with raising concerns has to be removed'

Nurse behind frosted glass Whistleblowing can be a frightening and daunting task and people feel it is easier not to speak out about bad practice. Photograph: Christopher Thomond for the Guardian

The term whistleblower often conjures up anxiety and fear in those wishing to raise concerns. Meanwhile, the response to those brave enough to do so can be defensive and doubting. This is enough to deter someone from coming forward to raise concerns.

I know from my experience at Mid Staffordshire how frightening and daunting a task it is to raise concerns in the workplace. There are many reasons why people feel that it is just easier to turn a blind eye and not raise your head above the parapet. While these reasons are often valid and must not be dismissed, it is vital that where problems exist those who witness them must speak out in order for things to change.

The stigma associated with raising concerns has to be removed. This can be achieved by increasing awareness of how to raise concerns safely and appropriately, so that it becomes not only expected, but also accepted. The option of whether you should act upon your concerns and blow the whistle should not exist. There are two main factors that prevent people raising concerns. Staff do not know enough about the actual process and they fear personal and professional repercussions.

All NHS trusts and organisations should provide standardised policies for raising concerns and deliver training and awareness of the process so that staff feel informed and empowered. It is vital for these trusts and organisations to promote the importance of raising concerns and offer reassurance and positive feedback to those who do. This united message would soon encourage people to raise concerns if they have them. If this is then evidenced by action rather than just words, the historic culture of people failing to speak out, or no effective action being taken if they do, will begin to change.

Those of us working in health and social care have a duty to act as advocates for the people we care for and this sometimes means speaking out when things are not right.

Through my own difficult personal experience I am clear that there is so much more that can be done to raise awareness and support staff who want to raise concerns. In my role as ambassador for cultural change, I hope the situations I faced at Mid Staffordshire, and what I learnt from them, can really help to encourage a more open and transparent culture across the partnership trust.

I want to encourage even greater professionalism, support staff to raise concerns and ensure that the voice of the frontline is heard clearly at a senior level within the organisation. I have a clear remit from partnership trust chief executive Stuart Poynor and the trust board to act freely and with complete autonomy from the management team, as another route for issues of concern to be raised at the highest level. This is essential and will help ensure an open transparent workforce.

My aim is to help empower staff to deliver an excellent service and be an ally for anyone on the frontline who is worried about raising concerns. I wish to hear the voice of those who are delivering care and services. I question:

• How supported do staff feel?
• Are staff confident that they know how to raise concerns?
• Have staff raised concerns in the past? What has been the response?
• Do staff feel listened to?
• What helps and hinders staff from doing their jobs well?
• What do patients/service users and relatives feel? 

I want staff to know that I am here as their support to improve the way we all work and ultimately give the best possible care.

Because of this role and my chief executive's forward thinking, I am optimistic about the future. The only way forward is to extend this type of role to all trusts. Trust boards throughout the NHS should embrace the concept and unite to help change the culture. We have a responsibility to protect and restore confidence in the NHS and, most importantly, protect those who need to use it.

Helene Donnelly is ambassador for cultural change at Staffordshire and Stoke on Trent partnership NHS trust.

This article is published by Guardian Professional. Join the Healthcare Professionals Network to receive regular emails and exclusive offers.


View the original article here