115亿美元天价！买了个“配角”：默沙东的清醒，与市场的误读

Core Insights - Merck's approval of Sotatercept in China marks the completion of a significant regulatory milestone following its $11.5 billion acquisition of Acceleron in 2021, indicating a strategic move to diversify beyond its blockbuster drug Keytruda [3][9] - Sotatercept is positioned as a risk-hedging asset rather than a new growth engine, with peak sales expectations of $3-4 billion, contrasting sharply with Keytruda's over $25 billion annual sales [4][5] Strategic Positioning - The drug serves as a stabilizing asset for Merck, helping to mitigate the impending loss of exclusivity for Keytruda in 2028, and aims to re-establish Merck's presence in the cardiovascular (CV) market [5] - Sotatercept's unique mechanism as the first activin signaling pathway inhibitor allows it to avoid direct competition with existing standard treatments, carving out a niche in the high-end market [5] Commercial Reality - Early sales performance of Sotatercept has been strong, with projected revenues of $419 million in its first year and $336 million in a single quarter of the following year, indicating a potential for significant market impact [6] - However, the drug faces structural challenges, including high reimbursement hurdles from insurers and additional monitoring requirements that complicate its prescription process [7] Chinese Market Dynamics - The rapid approval of Sotatercept in China reflects Merck's strategic focus on this market, but it also faces unique challenges, particularly regarding the payment capabilities of the patient population [8] - The drug's high cost limits its initial accessibility to affluent patients, necessitating negotiations for inclusion in national insurance schemes, which may require significant price reductions [8] - The competitive landscape in China is evolving, with domestic companies developing similar therapies, creating a limited window for Merck to establish a strong market presence before local competitors emerge [8]