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ICER casts doubt on Sarepta’s DMD gene therapy

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Good morning! A crowdsourced Readout today, to be sure, with contributions from STAT’s Jason Mast, Elaine Chen, and Jonathan Wosen. We get into earnings from Novo Nordisk, Amgen, and Illumina, and see that ICER is not so enthused about a gene therapy from Sarepta.

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Novo Nordisk CEO defends price of Wegovy, Ozempic

Novo Nordisk CEO Lars Fruergaard Jørgensen is standing by the cost of Ozempic and Wegovy, despite an ongoing Senate investigation into the company’s pricing. In an earnings call yesterday, he said the drugs offer “an attractive value proposition” as they’re priced similarly to earlier, less effective iterations of this class of drugs.

Although he conceded that the number of people taking the drugs “is to some degree putting strains on health care systems,” STAT’s Elaine Chen writes, the full value of these diabetes and obesity drugs has yet to be realized. Ozempic’s list price is $969 monthly; Wegovy’s is $1,349. Executives on the call said that the net prices for these drugs have already come down, and will continue to do so as more people take it — and as competition increases.

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On the ethics of live-brain research

The removal of small amounts of brain tissue from desperately ill patients, done as part of a Mount Sinai research project, triggered alarm bells at the FDA and has raised broader questions about the scientific and ethical justification for live-brain research. Journalist and STAT contributor Katherine Eban joins “The Readout LOUD” this week to discuss the findings of a two-year investigation.

Also on this week’s episode, STAT’s Adam Feuerstein and Allison DeAngelis discuss Novartis’ effort to acquire MorphoSys, and the latest news on Eli Lilly and Novo Nordisk’s blockbuster obesity drugs with Elaine Chen.

Listen here.

ICER casts doubt on Sarepta’s DMD gene therapy

From STAT’s Jason Mast: The drug-pricing watchdogs over at the Institute for Clinical and Economic Review, or ICER, often take a dim view of modern drug pricing — except when it comes to gene therapy. Those treatments, the nonprofit has said, often provide the years-long benefits for severe disease that justify a multimillion-dollar price tag.

Which makes the JAMA piece published this week by ICER CMO David Rind all the more notable. Rind considered Elevidys, Sarepta’s $3.2 million gene therapy for Duchenne muscular dystrophy. The treatment was given accelerated approval last year for 4- and 5-year-olds and, after a Phase 3 trial, the FDA is now considering whether to approve it for all ages.

That Phase 3 trial missed its primary endpoint, though, as did a previous smaller study. Sarepta has pointed to the results on secondary measures but given those data, Rind cast doubt on whether it should be approved — and certainly whether Sarepta should charge what other gene therapy companies do. “This is an enormous price tag for a therapy that has failed to meet its primary end point in the 2 randomized trials in which it has been studied and that is clearly not curative,” he wrote.

Amid a rocky year for genomics, Illumina revenue on track to stay flat

From STAT’s Jonathan Wosen: DNA sequencing juggernaut Illumina reported yesterday $1.06 billion in revenue for its core business during the first quarter of this year, down 2% from the same time last year, with the company’s execs reiterating that they expect 2024 revenue to essentially match the $4.5 billion from the previous fiscal year.

CEO Jacob Thaysen cautiously described the first-quarter numbers as a “decent start to the year” that exceeded expectations on a call with market analysts and investors. The updated numbers come during a turbulent time for the broader sequencing space. Pacific Biosciences, a Bay Area company that Illumina once unsuccessfully tried to acquire, recently laid off nearly 200 employees after reporting disappointing first-quarter sales. And while Illumina continues to control about 80% of the market, its shares are down 37% from a year ago and the firm faces growing competition from players such as Ultima, Singular Genomics, and Element Biosciences.

The San Diego genomics giant is still on track to finalize the terms of its divestiture of Grail — a cancer detection startup Illumina had acquired for $8 billion, drawing the ire of regulators in the U.S. and Europe — by the end of the second quarter of this year.

Amgen goes all in on injectable obesity drug

From STAT’s Elaine Chen: Amgen will scrap an early-stage obesity pill, and will instead focus on its more advanced injectable candidate called MariTide that’s seen as a potential competitor to Wegovy and Zepbound.

MariTide is in a Phase 2 trial for obesity, and CEO Bob Bradway said on the earnings call yesterday that “we are very encouraged with the results” from an interim analysis of that trial. The company is planning a “broad” Phase 3 program that will study MariTide in obesity, diabetes, and obesity-related conditions, and it’s already gearing up to make large amounts of the drug, initiating activities “to further expand manufacturing capacity with both clinical and commercial supply in mind,” Bradway said.

MariTide has an interesting mechanism — it’s a monoclonal antibody linked to two peptides that activates receptors of the GLP-1 hormone while blocking receptors of the GIP hormone. Even though that appears to contradictory to the mechanism of Lilly’s potent obesity drug Zepbound, which activates both GLP-1 and GIP receptors, MariTide has shown potential to induce potent and longer-lasting weight loss.

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