Under pressure, drugmakers dilute price hikes, but nothing is set in stone just yet — report

美国生物制药价格哄抬,药企压力徒增致销量和利润增长放缓

2018-12-17 08:15:04 endpoint News

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Biopharmaceutical price gouging has long enraged politicians and patients alike — mounting pressure on drugmakers to not appear like they put profit before patients — which has led to a slowing in size and frequency of price hikes, an analysis by Leerink concludes. The analysis echoes the findings of an Associated Press investigation — published this September — which indicated that although there were 96 price hikes for every price cut, the number and size of hikes decreased in the first seven months of 2018. Leerink’s analysis included 17 large biopharma companies — AbbVie $ABBV, Alexion $ALXN, Amgen $AMGN, Biogen $BIIB, Celgene $CELG, Gilead $GILD, JNJ $JNJ, Regeneron $REGN, AstraZeneca $AZN, Bristol-Myers $BMY, GSK $GSK, Eli Lilly $LLY, Merck $MRK, Novartis $NVS, Pfizer $PFE, Roche $RHBBY, and Sanofi $SNY. The most price-dependent growth companies between 2013 and 2017 were: Amgen, AstraZeneca, GSK, and Pfizer; and the least price-dependent were: Alexion, JNJ, and Regeneron. Overall, the number of price increases slowed this year by 31%, and the average size of the price increases fell by 40% — both measures falling to their lowest level in five years, the report finds. “The slowing of positive price effects means that industry growth is likely to be between 200 and 400 bps slower going forward than in the 2013-2017 period. This slower growth, and its associated effect on margins, profitability, and cash flow, may not be fully reflected in sector stock prices and multiples,” Leerink’s Geoffrey Porges said. The analysts also found that price contributions to sales in the United States have steadily declined from 11% in 2014 to 4% in 2017 and 2% YTD in 2018. Significantly, “the decline in the net positive price contribution to industry growth has more or less matched the decline in revenue growth over the same period of time,” Porges noted. However, the impact of slowing price increases will be powerful going forward — because it will stimulate the untangling of the cumulative effect of compounding from prior year price hikes. “Price increases are ‘the gift that keeps on giving’, since one year’s 10% price increase then increases the base of sales that then benefits from the next year’s price increases,” explained Porges. The Leerink team therefore set about calculating the impact of trailing price increases over the five-year period between 2013 and 2018. Cumulative positive US price has contributed ~$27 billion to global pharma revenue in 2014, ~$45 billion in 2015, ~$59 billion in 2016, ~$68 billion in 2017, and $71 billion in 2018. Reported global pharma revenue in 2018 is roughly $320 billion YTD, which without US price contributions from the prior five years would have been 22% lower, or roughly $250 billion YTD, they found. In other words, it looks like price growth alone has contributed on average 5%/year to industry growth over the last five years, and while total revenue growth was only 1% from 2017-2018, without the price effect, the analysts found that revenue growth from 2017-2018 would have actually fallen 6%. Following the release of President Trump’s blueprint for lowering drug prices in May, a plethora of companies pledged not to introduce their usual hikes in the middle of the year — however, whether this restraint will continue in the future remains to be seen. Since then the HHS has floated two proposals to thwart soaring prices for Medicare and its beneficiaries. Meanwhile, Merck raised the price of some of its major drugs in November, and Pfizer has announced it will increase the price of 41 drugs next month. “These companies are likely to be followed by a flood of peers, and then by inevitable responses and reactions from Washington. How this collision of interests plays out is anyone’s guess, and the administration’s creativity and inventiveness with respect to pricing proposals seem unlikely to be diminished in 2019. Ironically, the subject of drug pricing is probably one of the few genuinely bipartisan issues for both major parties, and further regulation or restrictions on drug pricing and price increases seem likely in our view to set up a showdown between President Trump, Congress and the Biopharma industry relatively early in the New Year,” concluded Porges. Charts: LEERINK
Leerink 的一项分析得出结论:生物制药价格的哄抬长期激怒了政客和患者——制药企业面临的压力越来越大,以至于它们似乎没有把利润放在患者面前——这导致了价格上涨的规模和频率放缓。 这一分析呼应了美联社( Associated Press )今年9月发布的一项调查的结果。调查显示,尽管每次降价都有96次提价,但2018年头7个月的提价数量和规模都有所下降。 Lerink 的分析包括17家大型生物制药公司—— AbbVie $ ABBV 、 Alexion $ ALXN 、 Amgen $ AMGN 、 Biogen $ BIIB 、 Celgene $ CELG 、 Gilead $ GILD 、 JNJ $ JNJ 、 Regeneron $ REN 、 AstraZeneca $ AZN 、 Bristol-Myers $ BMY 、 GSK $ GSK 、 Eli Lilly $ LLY 、 Merck $ MRK 、 Novartis $ NVS 、 Pfizer $ PFE 、 Roche $ RHBBY 和 Sanofi $ SNY 。 2013年至2017年间,最依赖价格的增长公司是安进( Amgen )、阿斯利康( AstraZeneca )、葛兰素史克( GSK )和辉瑞( Pfizer )。报告发现,总体而言,今年价格涨幅放缓了31%,平均涨幅下降了40%,这两项指标均跌至5年来的最低水平。 “积极价格效应的放缓意味着,未来行业增长可能会比2013-2017年期间慢200至400个基点。这一增长放缓及其对利润率、盈利能力和现金流的相关影响,可能不会完全反映在行业股票价格和市盈率上,” Lerink 的杰弗里?波格斯( Geoffrey Porgs )表示。 分析师还发现,对美国销售的价格贡献从2014年的11%稳步下降到2017年的4%和2018年的2%。 重要的是,“对行业增长的净正价格贡献的下降或多或少与同期收入增长的下降相匹配,” Porges 指出。 然而,放缓的价格上涨的影响将是强大的未来,因为它将刺激解决累积效应的复利从前一年的价格上涨。 Porges 解释说:“价格上涨是‘持续给予的礼物’,因为一年的价格上涨10%,然后增加销售基础,然后从明年的价格上涨中获益。” 因此, Lerink 团队着手计算2013年至2018年五年间跟踪价格上涨的影响。美国药品价格的累计正值为2014年全球医药收入贡献了270亿美元,2015年贡献了450亿美元,2016年贡献了590亿美元,2017年贡献了680亿美元,2018年贡献了710亿美元。 他们发现,2018年报告的全球医药收入约为3,200亿美元,如果没有美国前五年的价格贡献,这一数字将下降22%,约为2,500亿美元。 换句话说,过去五年,仅价格增长一项对行业增长的贡献平均为5%/年,尽管2017年至2018年总收入增长仅为1%,但分析师发现,如果没有价格效应,2017年至2018年的收入增长实际上将下降6%。 在特朗普( Trump )总统在5月份发布了降低药品价格的蓝图之后,很多公司承诺不会在今年年中实施通常的加息——然而,这种限制在未来是否会持续还有待观察。此后,美国卫生与公众服务部提出了两项建议,以阻止医疗保险及其受益人价格飙升。 与此同时,默克公司在11月上调了部分主要药品的价格,辉瑞公司已宣布将在下月上调41个药品的价格。 “在这些公司之后,可能会有大量的同行,然后是来自华盛顿的不可避免的反应和反应。人们猜测,这种利益冲突是如何发生的,而政府在定价方案方面的创造力和创造力似乎不太可能在2019年减弱。具有讽刺意味的是,药品定价问题可能是两大主要政党中为数不多的真正两党合作的问题之一,我们似乎有可能对药品定价和价格上涨进行进一步的监管或限制,以便在新的一年中,在特朗普总统、国会和生物制药行业之间建立一个摊牌,”波格斯总结道。 魅力:精英

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