由特朗普政府與兩大減肥藥生產商，即禮來（LLY）和諾和諾德（NVO），在上周五終於達成里程碑式的藥物協議。根據協議，美國政府醫療保險計劃Medicare，將以遠低現行價為6,600萬參保人，提供重磅減肥藥GLP-1藥物Zepbound與Wegovy的保險保障。此外，政府直銷渠道還將為患者提供低價藥物。該重大協議將使數千萬以往無力負擔此類藥物的民眾獲得治療機會。儘管定價下調，但市場規模卻變得更龐大，將刺激禮來、諾和諾德等供應商銷量與營業額增長。
雖然新政策有部分限制，但多數Medicare參保人將獲得保障，使GLP-1藥物市場在12至18個月內從目前的850萬人，大增至4,000萬人。至於美國政府保險計劃未來對肥胖藥及低劑量藥物支付價格將降至少於350美元，遠低於目前1,000至1,300美元。值得留意是，現時36%私營商業健康保險計劃涵蓋GLP-1藥物，一旦上述情況實施，將有望擴大整個GLP-1藥物市場規模。
除保險保障外，美國政府TrumpRX亦計劃以每月僅350美元提供上述藥物，符合患者兩年內相關費用更有望降至250美元。另一方面，禮來與諾和諾德新開通直銷渠道，定價500美元或略低，但已遠低於保險計劃定價。再者，待新型肥胖藥丸獲批上市後，價格可能更為親民。
儘管個別州份獲取政府資金未必順利，但由於價格降低，配合GLP-1能有效節省政府長期醫療負擔，因此連公共保險計劃Medicaid，預計也將在多數州份迅速承保。過去兩年多來，此藥物不單能成功解決肥胖問題，還對患者長期健康效益與削減醫療成本成果功效顯著，將有望令Medicaid與商業保險計劃擴大覆蓋範圍。
減價卻大增市場規模
對禮來與諾和諾德兩大供應商來講，雖然定價大幅下調，但銷量激增， 變相有重大利好作用。更重要是初期研發成本已在過去兩至三年從巨額銷售中回本，未來減價就是開拓大眾市場的必經之路。
因此，以合理降價換取未來五倍的市場規模，對藥企來講利多於弊。諾和諾德早前股價因自身管運問題下挫，目前仍需時間消化。相反禮來表現出色，在GLP-1藥物市場具有明顯優勢，尤其奪得更多市場佔有率。雖然受美國政府談判不確定性的影響，禮來股價跑輸大市兼仍低於歷史高位，但隨著新協議落實，將消除不確定性因素，令股價有望延續近期反彈勢頭，兼挑戰歷史高點，投資者應把握機會收集作長期持有。
Landmark GLP-1 drug deal to improve US patients’ health and may boost Eli Lilly shares
A true landmark weight-loss drug deal by the Trump’s White House and the two providers Eli Lilly & Novo Nordisk was announced last Friday. Under the agreement, the major US government health insurance Medicare will provide coverage to 66 million members on the blockbuster weight-loss GLP-1 drugs Zepbound & Wegovy at much lower prices. On top, the government direct-to-customer channel will provide lower priced drugs to patient. This major agreement will bring access for tens of millions of people & patients that cannot afford these drugs before. Despite at lower prices, a much bigger market would boost unit and total sales of Eli Lilly & Novo Nordisk as well as other new providers.
Although there are some constraints, most Medicare members could be covered to expand their market of GLP-1 drugs from 8.5 million now to 40 million in 12-18 months. Instead of the high US$1,000 – US$1,300 per month, the government insurance would only need to pay US$350 or lower for future obesity pill and lower dosage later. This would only pressure other commercial insurance plans to provide coverage to their private members to boost the Total-Addressable-Market (TAM) even more. At the moment, only around 36% of private commercial health insurance plans provide some type of coverage to GLP-1 drugs.
Besides insurance coverage, US government TrumpRX would provide these drugs at only US$350 per month soon and that could drop to US$250 in 2 years to qualified patients. In addition, new DTC channels of Eli Lilly & Novo Nordisk for US$500 or slightly lower, already much lower than their list prices for insurance plans and that would ease further in the future to US$300 for low dosage. When the new obesity pills are approved & ready, the price could be even lower.
Although securing government funding may not be too easy especially in some states, but the other major US public insurance Medicaid could see most states providing coverage soon too due to lower prices and the importance of lower long-term medical cost GLP-1 drugs will save the government on these programs. After over two years of successful track records of these drugs to tackle weight issues and studies on how much health benefit would these patients enjoy that would slash their health cost for the next few decades for them and for their insurance programs. Coverage from Medicaid plans as well as private commercial insurance plans will increase substantially.
