“The ASX 200 inclusion sugar hit just finished. Weeeeeeee!”
@PledgeI thought the inclusion date for the ASX200 was the 6th March , or am I mistaken ?
I thought Ryoncil was the
only authorised therapy for paediatric steroid refractory acute graft versus host .
Do you think no one will die from the latter disease this year and there will be no patients ? Pray tell who gave you this exclusive ?
Maybe these clever shorters who were wrong about the pricing, potency assay and the ability of the Company to refinance itself , have suddenly made another scoop? Quick as a flash , the ASX200 story has disappeared.Has anyone reminded them that active funds who shadow track passive indices using equal weight strategies or other outperformance methodologies, will also want to join the party, post ASX200 inclusion. No folks , this is not like your first attempt at coitus , this is going to be a tantric experience to enliven the senses. Lets all take our time on this rodeo.
Or maybe they have been running up naked shorts as they have in the past, in addition to the 2% Nasdaq declared short position and the 2.9%+ Shortman disclosure over in Australia ? That’s a lot of stock , if they let the price rise I guess it would be just as expensive as trying to hold the price down at this point ?
So what has emboldened our shorting friends ? I suspect the answer is paperwork and the much publicised blow up of Bluebord Bio ?
But the thing is , the demise of Bluebird Bio was a classic case of Vertex Pharma whose share price has soared to a peak market cap of US$124bn! stealing its lunch from under its nose, as both therapies for sickle cell, were approved at the same time. Vertex was reportedly outselling Bluebird by 5 to 1 in one quarter , with a price point around $1m cheaper.Incredibly , Bluebird even decided to push ahead with pricing that was adjudged to exceed its opined “economic value” by ICER and there was a black box warning on the label to boot. The irony was, that despite all of those prevailing winds, Bluebird was still able to ramp up sales materially quarter on quarter taking bookings well into the following year and was forecast to break even in mid 2025…but they were depending on a further paediatric review voucher from the FDA to provide interim financing which never materialised . I enclose some links detailing the whole story . Rather than take my word for it you can still listen to the last quarterly earnings call where Bluebird pointed out that its reimbursement rate not been ultimately rejected by one insurance company and they had coverage now in place for approx 200m of the population in the first 10 months since authorisation.
Contrary to the siren voices on this thread, CMS still
agreed reimbursement rates for both Bluebird’s Lyfgenia and Vertex’s Casgevy less than a year after approval . This surprised me because unlike Ryoncil , sickle cell is not typically life threatening but obviously can severely impact the quality of life, impact cognitive development and shorten lifespans over a much longer timeframe. The problem is the theoretical lifetime treatment costs of $5-6m are stretched out over decades and if proper discount rates are used against future costs they look to have mispriced the cost economic value ..which might explain Vertex undercutting them . As SIlviu has pointed out many times, MSCs do not suffer from some of the high fixed initial production costs and process failure rates of autologous or some gene editing therapies. Bluebird stated they needed 160 patients annually to reach cash flow breakeven to pay for all the quality technical centres set up to handle throughput …and they only just missed their target. Some of it was just bad luck, such as when seven patients booked in for treatment in one quarter,had to reschedule treatment because of the hurricanes hitting the south of the USA last year.
https://www.biospace.com/policy/bluebird-vertex-crisprs-scd-gene-therapies-get-new-cms-payment-modelhttps://www.fiercepharma.com/pharma/fda-approves-bluebird-sickle-cell-disease-gene-therapy-can-lyfgenia-overcome-crisprs-halohttps://www.fiercepharma.com/pharma/bluebird-will-not-play-vertex-deciding-price-its-lovo-cel-gene-therapyIn summary, Bluebird Bio failed because of the emergence of an equally efficacious competitor . Cash flow was no doubt impacted by payers needing a few months longer to approve , but NOT, because insurers or Medicaid would not ultimately pay for the treatment Their senior creditor Hercules was able to walk away without a mauling but shareholders must have wondered if their pockets had been picked.
As Vertex hovers near an all time high , i believe our investment case remains intact . Ryoncil pricing is based on making far greater savings on an average treatment relative to 12 month total post operative hospitalisation costs. May i also point out the peer reviewed savings identified in the Grabner et al study Mesoblast refers to were based on average index costs from over 10 years ago . We are not a bespoke medicine needing upwards of 100 days to formulate and process. Our refractory patients will usually die within 100 days so there is no opportunity for an insurance company to kick this one down the road.
Ironically, as people micro analyse when Ryoncil sales will ramp for sr aGVHD…because they WILL in my opinion …investors are being distracted from the acceleration in recruitment now under way for the blockbuster Chronic Lower Back pivotal 12 month phase three trial OR the imminent pre BLA meeting which is about to be scheduled with the FDA for cardiac accelerated approval opportunities in April. Lest we forget , GVHD is the frickin Hor doeuvres. We have not even scratched the surface. Did someone dream of an off label tsunamis or was it just me ? Within a few years I expect to see Mesoblast challenging the likes of Vertex, which has been a stellar performer. Sometimes you have to separate the wheat from the chaff. OP
Please do not rely on the thoughts or opinions expressed in the above post when making an investment decision.
