If biotech investors were hoping that the election of Donald Trump as the next president of the United States would mean an end to the risk of drug price controls, they might be mistaken.
During a press conference last week, Trump called out drug companies for "getting away with murder" in terms of drug prices, and his jawboning on drug prices could mean that companies marketing expensive medicines, including Celgene Corp. (CELG), could find themselves in Trump's crosshairs in 2017.
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Digging into the details
Revlimid is widely used in first- and second-line multiple myeloma treatment, and it represents about 60% of Celgene's revenue. While Revlimid is a lifesaving medicine used in thousands of multiple myeloma patients every year, its six-figure annual price tag means it's a far cry from inexpensive.
So far, high-cost cancer therapies like Revlimid have avoided a lot of the pushback on pricing out of Washington, but that could change given that the cost of these medicines has drawn the ire of cancer-care providers, including the highly regarded Memorial Sloan Kettering Cancer Center, in the past.
For example, 100 leukemia experts joined together in 2013 to question the morality of "astronomical" leukemia drug prices, and in 2014, Memorial Sloan Kettering singled out Celgene's Abraxane as an example of a drug that delivers modest benefits in pancreatic cancer at a "steep cost."
Cancer-drug makers haven't avoided the sting of rebuke from Washington altogether, either. Although Trump hasn't singled out any one cancer-drug maker on pricing, former presidential hopeful Bernie Sanders has. In October, Sanders lambasted Ariad Pharmaceuticals for a history of price increases on its leukemia drug, Iclusig, which costs $199,000 per year.
Trump takes aim
Trump is famous for shaming companies on Twitter because of their policies and practices, and automakers and defense contractors are among his favorite targets so far.
Since his election, Trump has blasted General Motors for producing vehicles in Mexico, and just this weekend, he took on BMW, claiming that the German carmaker could face 35% import taxes, if it plans on making its cars south of the border and selling them in America.
Trump has also taken on Boeing and Lockheed Martin, the makers of Air Force One and the F-35 fighter jet, respectively, because of their history of high costs.
In these cases, Trump's public lambasting has seemed to produce results. General Motors reported earlier today it's investing $1 billion in the United States, and previously, both Boeing and Lockheed Martin have suggested they're going to get more aggressive at keeping their costs in check.
Those successes could embolden Trump to take similar aim at individual drug companies, if they don't play ball. Last week, he blasted drug companies for their pricing behavior, and over the weekend, Trump said he plans to reshape how Medicare and Medicaid pay for drugs, allowing them more flexibility to negotiate savings.
In the crosshairs?
Revlimid's retail price was $85,000 in 2010, according to Morningstar, and last year, Revlimid's wholesale acquisition cost was $121,800, according to the trade group America's Health Insurance Plans. That implies compound annual growth of 6.06%, which is about in line with Cowen & Co.'s estimate of a history of price increases of about 6% per year. That's lower than the double-digit price increases that have captured significant media attention; however, it's still more than double the rate of inflation.
Furthermore, Celgene's decision to increase Revlimid's price multiple times between 2015 and 2016 could raise eyebrows. Cowen & Co. reported last year that Revlimid's price was increased 3% in June 2015, 4% in October 2015, and another 6.8% in March 2016.
According to Celgene's management, the company gets about one-third of its annual sales growth from price increases, and the rest of its growth from unit volume resulting from expanding the use of its drugs into more patient indications.
Looking ahead
Celgene is arguably one of the most successful biotechnology companies in the world. It's also one of the few biopharma companies to offer investors long-term growth forecasts.
Last week, Celgene told industry watchers at a key conference that its sales and earnings per share could exceed $13 billion and $7.10, respectively, in 2017, and then climb to over $21 billion and $13 in 2020. A big driver of that success is expected to be Revlimid, which generated nearly $7 billion in sales last year, and is anticipated to generate more than $8 billion in sales this year.
Undeniably, Celgene appears to have been more judicious about its price increases in the past than peers, but the high cost of its medicine still puts it at potential risk for increased scrutiny. At a maximum, investors should consider the potential downside that could be caused by a Trump Twitter-storm, and at a minimum, model in less potential growth for Celgene from pricing than they have in the past.
