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Celgene Corporation Message Board

  • rob_cos rob_cos Oct 29, 2013 11:16 AM Flag

    DB CELG - *Apremilast a belle of the ACR ball*

    DB CELG - *Apremilast a belle of the ACR ball*
    Our key take from attending ACR this weekend for Apremilast: we came away more bullish on PsA (psoriatic arthritis) launch from our checks around drug's profile. We continue think Apremilast launch consensus ($114M) in '14 is beatable, but highlight opportunities for upside in price & other populations.

    Consistent Apremilast safety and lab profile is resounding w docs. Awareness in the rheum world was high at the meeting

    Celgene presented Palace-3 (pts with skin lesions) and pooled Palace 1-3 data to a standing room only crowd of rheums on Sun. Interestingly, a big portion of the room left post Apremilast data. We spoke to docs and notable comments were around safety profile in light of efficacy. Apremilast GI effects are mild and happen in first two weeks. In the real world, we could see rheums titrating to manage the effects no matter how modest.

    We would expect the US price to be on the high end of $10-15k based on totality of Apremilast profile

    We think need for no labs (in addition to benign safety) may be a real payer advantage. Lab abnormalities are under 1pct in pooled data (most common lab was ALT at around 1pct). We also think mgmt comments at analyst day suggest confidence in profile of drug so we don't expect them to give away economics here. We currently model US pricing for Apremilast at $13k annually (20% discount ex-US). If we assumed $15k, the impact to our FV is $2/sh.

    Pricing higher, but still at a discount to biologics would not concern us for uptake. We see limited read from Xeljanz RA launch to Apremilast

    We took a RA poster data tour hosted by a leading KOL with many docs on the tour. Safety (infections, cancer and lipids) was highlighted as the primary issue with Xeljanz in this tour. The high cost ($25K) on top of tough safety makes it a non-starter in the community doc world. It was not approved in the EU. Apremilast has far better safety as perceived by rheums and will be priced at a dis

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