RE:RE:Taimed's Conference May 31 of 2021 Great answers, my focus is mostly on 1) to explain Trogarzo's poor sales. Research has come out since launch, mostly sponsored by Viiv, to get a better understanding of the MDR population. That research shows these patients are far more stable in their viral counts than was previously thought. That stability came with the launch of drugs such as Dolutegravir in 2014. It was known this drug brought more stability to the general hiv population but it took until 2019 for research in the MDR cohort to see it was doing the same there. So I think it's correct that there are 15,000 to 20,000 MDR patients but it's not correct that they all need Trogarzo. The vast majority are stable (maybe two thirds) and the shift from stable to unstable is very slow. That probably leaves about 5000 who struggle to control their virus. Trogarzo has been positioned by doctors (and its label) as the drug of last resort so it's a very slow process to bring that smaller number of unstable patients onto the drug. In very general terms I think Paul is trying to breakout of that very narrowly defined role for the drug by engaging with patients and doctors. Given they are chasing IM it must be that they think (or more likely have evidence) that IV is part of the cause for that narrow role.
I think if you are playing the long game with Trogarzo you might see it's profile improve if once per month injections become a part of the treatment options for other hiv drugs and Trogarzo can slip into that with it's IM version but that doesn't help with short term sales.
SPCEO1 wrote: Thanks again for your Taimed update. Please see my responses in red below:
stock38 wrote:
Dear all
Is there anyone who can tell me the reason why the sales of Trogarzo is so bad. I have some guesses and do not know right or not. Would appreciate to have your comments and instructions.
When TH signed the deal with Taimed, they said at that time they expected sales of Trogarzo to be about equal to those of Egrifta. Only later did they change their mind and indicate that sales would be much greater than Egrifta's sales. The research that led TH to increase their sales forecasts was clearly very flawed. I do think they actually believed what they were saying as we did not see any insider selling at the top in May of 2018 and they likely would not have issued a convertible at that time if they did not believe what they were forecasting. The former head of sales did blow out most of the stock she owned a few months before the stock hit its peak (and well below the peak level it reached shortly thereafter) so perhaps she knew the sales forecasts had a good chance of being inaccurate. But, to my mind, the sales of Trogarzo were not bad, the upgraded forecast for demand of Trogarzo was what was bad.
1. Both Taimed and TH said loudly at the beginning that Tro.is a
life saving drug about 10000 to 15000 people are waiting it to
save lives. But the truth is that these people did not die without
Tro. They actually can use current drug other than Tro.and still
live well (maybe no well owing to the side effect of the drugs
they were using). So this lifesaving disclosure is over
exaggerated or only kind of propaganda anyway( in this case
the blame should be put mainly on Taimed who is the
procducer.
The blame is TH's not Taimed's. They are the ones who came up with that unrealistic forecast. Clearly, the IV aspect was a factor in the drug not being used as expected and we will see just how big a factor that is when the IV Push becomes available and then the IM version. But doctors were happy to keep adjusting their MDR patients old medications that were not working as well as they could, but well enough apparently, rather than switch those patients onto Trogarzo, which almost certainly would ahve been better for those patients.
2. Most MDR patients were underprivileged groups. Maybe
already lost their jobs and live miserably , so they can not buy
insurance to cover Tro. If they apply to social assistance , they
have to struggle to get permission which is no easy
cause the budget is limited. In short , Tro.is good but the
patients could not afford it. So the good efficacy means little for
customers. The sale prospect is very dark it has few chance to
go further.
What you are suggesting here is not really accurate. Indigent MDR patients can easily recieve the medical care they need via MedicAid. The budget is not limited and drugs like Trogarzo are covered. The problem with these type of patients is they just are so zoned out on drugs or mental health problems that they do not go to the doctor to get a prescription or, even if they do, they don't show up for their appointments. You may remember that TH took account of this in their early projections about the market size but I am not sure what they did with this group in the revised market projection.
3. TH was unable to promote Tro. either because of their sale
force or unproper strategy or both. In this case people may
wonder if NASH project develops well, can they sell it well .
Of course they can sell loyalty to others, that is another story.
It is common to blame the sales force or the sales management when a drug comes up short of its expectations but I suspect this is rarely accurate. If a drug fits a need, it sells regardless of the quality fot he sales force or the techniques used to market it. Those things help or hurt on the margin but rarely does a bad drug sell well because of great salespeople or clever marketing strategies. In Trogarzo's case, the doctors of the MDR patients just did not see a need for it for most of their MDR patients - only the most deperate got the drug.
4. Now Taimed and TH are developing IV push and IM push. Do
these two kinds of injection really help sales a lot or just let
patients have more options.
Time will tell. I believe these new versions will help some but not enough to make a huge difference in how you view Trogarzo's prospects. Even if Trogarzo sales doubled because of these new forms of drug administration, I doubt this would push either TH's stock or Taimed's stock back to its previous highs. But there should be some positive impact from these new versions.
5. TH made some payments to Taimed with their shares. I do not
know exactly how much shares Taimed has . But I once asked CFO of Taimed , why they did not charge TH with cash. He
told me Taimed also paid their loyalty fee to other firms
with shares and finally they got five times profits because
Taimed shares went high. Since Taimed was so confident
about Tro. They even issued a statement that permit their staff
have the right to buy Taimed's share at the price
of NT$180/share.The report showed that both CEO and
CFO bought many shares at this price(they do not sell till
now). And now since the sales of Tro.is so frustrating that TH
and Taimed's share plunged and plunged heavily. Right now
Taimed's price is only NT$70 and the statement became a
sad joke
Taimed probably still owns the TH shares they have received but I cannot say so for sure. It may well pay off quite nicely for them if TH's cancer and/or NASH programs grab the attention of investors.
6. I ho not know exactly how much shares of TH Taimed has.
But the CFO told me once that if TH increases C$1.--, Taimed
will benefit about 45 millions Taiwan dollars . so these two
companies really bind together. You can imagine that Taimed
already lost lot of money in TH’s share.
I can't remember the prices they got the TH shares at but they might not be at a loss at all or it may not be a large loss if there is a loss at this time. I am prettys ure they got the shares at good prices. Certainly the first tranche of shares they got when the deal was origianlly announced were priced quite low.
Thanks for your attention for reading this long letter
Stock 38 from Taiwan