华夏时报记者 杨燕 北京报道 美东时间7月31日清晨，特朗普在其自创社交平台Truth Social发帖，罕见地以扫描附件形式公布了17封 落款为"Donald J. Trump"的总统亲笔信。收信人名单几乎囊括了全球制药业的"银河舰队"——辉瑞、强 生、诺和诺德、艾伯维、阿斯利康、默沙东、赛诺菲等17家跨国药企的CEO悉数在列。 信件开篇即给出"倒计时"：从当日算起60天内，即到2025年9月29日午夜前，企业必须书面承诺并启 动"可验证、可量化"的降价举措，否则"本届政府将动用一切可用工具保护美国家庭免受药价暴利之 害"。 几乎同一时间，辉瑞、默沙东、礼来的股价在盘前交易中应声下挫。这似曾相识的一幕，将美国社会最 敏感神经之一——处方药价格问题，再次推至风口浪尖。 风暴中心：总统的"最后通牒" 从各家回应来看，药企普遍将责任推向供应链中游（PBM、保险公司），强调自身援助计划的作用， 但对系统性、大幅度降低药品标价——尤其是高利润的创新药和专利保护期内药物——态度暧昧或直接 回避。 "当前中美之间的创新药市场和BD交易多数是以license out的形式展开，涉及具体的药品出口的体量非 常小，药品"降价潮 ...

Group 1: Core Message - Trump issued a "last ultimatum" to 17 major pharmaceutical companies, demanding written commitments for verifiable and quantifiable price reductions within 60 days, or the government will take necessary actions to protect American families from high drug prices [1][2][3] Group 2: Pharmaceutical Companies' Responses - Pfizer emphasized its patient assistance programs and mentioned limited discounts on specific insulin products but did not commit to broad price reductions [2] - Merck reiterated its commitment to accessibility but avoided discussing price reductions for mature drugs [2] - Eli Lilly announced a significant price cut of 70% for its insulin products, positioning itself as an industry leader in this regard [2] Group 3: Historical Context and Implications - Trump's actions are a continuation of his previous efforts to reform drug pricing during his presidency, including attempts to implement the Most Favored Nation (MFN) pricing model [3] - The current political pressure on pharmaceutical companies may lead to limited price reductions, but systemic reforms are necessary for lasting change in drug pricing [8][9] Group 4: Drug Pricing Trends - The median launch price of drugs in the U.S. has increased dramatically, from $2,115 in 2008 to $180,007 in 2021, indicating a nearly 90-fold increase [4] - The average price of prescription drugs in the U.S. is approximately 2.56 times higher than in other OECD countries, with some innovative drugs priced up to 10 times higher [7] Group 5: Industry Dynamics and Challenges - The complexity of the U.S. drug pricing system, including the roles of Pharmacy Benefit Managers (PBMs) and insurance companies, contributes to high out-of-pocket costs for patients [7][8] - The pharmaceutical industry faces a delicate balance between incentivizing innovation and ensuring drug accessibility for patients, with potential negative impacts on future research and development funding if prices are forced down [10]

Core Viewpoint - The article discusses the complexities and challenges of drug pricing in the United States, highlighting the significant price disparities compared to Europe and the underlying factors contributing to these differences. Group 1: Trump's Executive Order and Its Implications - Trump's executive order aimed to reduce drug prices by 30%-80%, but lacked a clear implementation plan, leading to confusion and a rise in pharmaceutical stock prices instead of a decline [2][4][5]. - The historical context reveals that U.S. law prohibits the government from negotiating drug prices directly with pharmaceutical companies, rooted in the philosophy of maintaining a separation between government and business [6][10][13]. Group 2: Drug Pricing Mechanisms - Drug prices in the U.S. are significantly higher than in other developed countries, with some medications costing 5-10 times more [15][52]. - The pricing mechanism involves multiple channels, including government insurance and commercial insurance, each with different pricing strategies and negotiation dynamics [29][30]. Group 3: Global Drug Price Comparisons - In Europe, drug prices are generally lower, with examples showing that the same medication can cost around $500 in Europe compared to $1000 in the U.S. [52][53]. - The article notes that while some rare disease medications are still expensive, the overall trend shows that U.S. drug prices are often higher due to various market dynamics and negotiation practices [56][58]. Group 4: Industry Dynamics and Future Considerations - The pharmaceutical industry is characterized by a complex interplay of innovation, pricing strategies, and regulatory frameworks, which influence the development and pricing of new drugs [47][68]. - The introduction of negotiation mechanisms in the U.S. under the IRA Act reflects a shift towards more competitive pricing, similar to practices seen in other countries [67][68].

Investment Rating - The report maintains a "Buy" rating for Legend Biotech (LEGN US) with a target price of $65.00, indicating a potential upside of 100.7% from the current price of $32.38 [1][8]. Core Insights - Carvykti is experiencing steady growth, with a 10% quarter-over-quarter increase in 1Q25 sales, driven by new production capacity, new indications, and market expansion. The report suggests that the current market concerns regarding competition and drug pricing reforms are overstated, supporting the "Buy" rating [2][4]. - The revenue forecasts for Legend Biotech have been adjusted downward for 2025, 2026, and 2027, reflecting a 9.5%, 5.4%, and 1.8% decrease respectively. The projected revenues are $960 million, $1.4 billion, and $1.797 billion for those years [3][9]. Financial Projections - The updated financial model predicts the following for Legend Biotech: - 2025E Revenue: $960 million - 2026E Revenue: $1.4 billion - 2027E Revenue: $1.797 billion - 2025E Gross Profit: $596 million with a gross margin of 62.1% [3][9]. - The net loss for 1Q25 was reported at $101 million, but adjusted net loss excluding non-operating items was significantly reduced to $27 million compared to a net loss of $85 million in 1Q24 [4][9]. Market Performance - The stock has shown a year-to-date change of -0.49%, with a 52-week high of $59.88 and a market capitalization of approximately $5.95 billion [2][9]. - The report highlights that the market is currently undervaluing the stock, as it trades at 1.7 times the peak revenue multiple, indicating significant investment value [4][5].

Summary of Key Points from the Conference Call on U.S. Pharmaceutical Pricing Reform Industry Overview - The U.S. healthcare system consists of Medicare, Medicaid, and commercial insurance, with Medicare covering the elderly and disabled, funded by taxes and subsidies, while Medicaid is jointly funded by federal and state governments for low-income individuals [1][2] - The U.S. has the highest healthcare spending among developed countries, accounting for 16.5% of GDP in 2022, yet has a relatively low average life expectancy, indicating systemic deficiencies [3] Core Insights and Arguments - Both the Trump and Biden administrations have attempted to lower drug prices through various means, facing significant challenges [1] - The Biden administration's Inflation Reduction Act (IRA) set price caps on certain high-cost drugs, resulting in significant price reductions for some medications, such as a 56% reduction for a blood clot treatment and a 66% reduction for a diabetes drug, while negotiations for cancer drug ibrutinib failed [1][4] - The federal government does not directly intervene in commercial insurance drug pricing; instead, commercial insurers negotiate discounts through Pharmacy Benefit Managers (PBMs) [5][6] - PBMs control costs through strategies like substituting generics and establishing prescription guidelines, with the Trump administration favoring market liberalization and the Biden administration relying on inflation-linked negotiations [1][7][8] Additional Important Content - Trump's proposal aims for a universal drug price reduction of 30%-80%, which may pressure pharmaceutical companies to adjust their R&D strategies and global pricing structures, though such drastic cuts could hinder innovation [2][10] - Cross-national pharmaceutical companies may respond to the most-favored-nation pricing policy by launching special versions of drugs or adjusting prices to maintain market stability [11] - The disparity between list prices and actual payment prices in the U.S. can affect the perceived effectiveness of price reductions, as insurance companies often negotiate lower prices than those advertised [13] - The impact of price caps on the innovative drug industry could lead to significant changes in product offerings and pricing structures, potentially delaying the market entry of new drugs [14][15] - The Biden administration's negotiation policies primarily affect Medicare, which covers high-cost innovative drugs, while commercial insurance may follow suit if Medicare successfully lowers prices [22][23] Conclusion - The ongoing debate over drug pricing in the U.S. reflects broader issues within the healthcare system, with significant implications for pharmaceutical innovation, market dynamics, and patient access to medications. The effectiveness of proposed reforms remains to be seen, particularly in light of potential legal challenges and industry resistance [12][27]

Group 1 - Trump's announcement to sign an executive order mandating a 30%-80% reduction in prescription drug prices has caused significant market volatility, particularly impacting Chinese biotech firm BeiGene, which saw a 10% drop in stock price on May 12 [1] - The biopharmaceutical sector experienced a rebound on May 13, with companies like Junshi Biosciences and BeiGene recovering some losses, indicating a complex market reaction to the announcement [1] - The announcement reflects deeper issues within the U.S. healthcare reform landscape, highlighting the political challenges and the lack of a clear implementation path for such policies [2] Group 2 - The U.S. pharmaceutical pricing system is characterized by a high investment cycle, with the top ten global pharmaceutical companies, eight of which are American, investing a total of $120.5 billion in R&D in 2023 [3] - The lobbying efforts of the Pharmaceutical Research and Manufacturers of America (PhRMA) are significant, with political contributions reaching $382.6 million in 2023, a 67% increase from 2016, indicating the industry's strong influence on policy [3] - The American Medical Association (AMA) controls pricing for medical services, which affects insurance premiums and creates a closed-loop profit chain among patients, insurers, and pharmaceutical companies [4] Group 3 - The U.S. healthcare reform challenges stem from the interplay of market beliefs, decentralized governance, and populist political demands, complicating any unilateral executive actions [5] - Legal challenges may arise from the Takings Clause of the U.S. Constitution, which protects corporate property rights, potentially hindering the implementation of price controls [5] - Cultural resistance to government intervention in healthcare is prevalent, with 63% of Americans believing that such actions would lower the quality of care, complicating the acceptance of unilateral pricing policies [5] Group 4 - The market reaction to Trump's pricing announcement reflects a pessimistic outlook on the uncertainty surrounding pharmaceutical companies, particularly in the context of global pricing dynamics [6] - The disparity in drug pricing between the U.S. and China highlights the critical role of the U.S. pricing system as a valuation anchor for global biopharmaceutical innovation [6] - Successful healthcare reforms in other countries, such as Germany and Japan, demonstrate that market access and affordability can coexist, suggesting that a balanced approach is necessary for U.S. healthcare reform [6] Group 5 - Chinese pharmaceutical companies are increasingly focusing on global expansion, leveraging technological advancements and compliance strategies to navigate market challenges [7] - Companies like BeiGene and Junshi Biosciences are establishing production bases in the U.S. to mitigate tariff risks and integrate into the global supply chain [7] - The recent policy turbulence underscores that Chinese innovative drug companies are evolving from followers to leaders in setting industry standards, as evidenced by significant licensing deals and advancements in cutting-edge therapies [7]

Core Viewpoint - The potential U.S. drug price reform poses a negative outlook for Indian pharmaceutical stocks, despite the uncertainty surrounding the feasibility of Trump's plan to lower prescription drug prices [1] Summary by Relevant Categories Impact on Indian Pharmaceutical Companies - Indian pharmaceutical companies involved in brand and specialty drugs are expected to be the most affected by the potential price reductions of 30%-80% [1] - Generic drug manufacturers are likely to experience minimal impact from these proposed changes [1] U.S. Drug Pricing Context - The high cost of drugs in the U.S. is attributed to the insurance system and the profit margins of intermediaries [1] - Simply lowering surface prices may not effectively address the underlying issues of drug pricing in the U.S. [1]

Group 1 - The core viewpoint of the news is that President Trump plans to sign an executive order to enforce a global minimum drug price in the U.S. to lower prescription drug costs [1] - Trump claims that U.S. citizens pay significantly higher prices for prescription drugs compared to other countries, sometimes five to ten times more for the same medication [1] - The implementation of the "most favored nation" policy is expected to align U.S. drug prices with those of countries with the lowest prices, potentially reducing U.S. drug costs by 30% to 80% [1] Group 2 - The Biden administration has initiated price negotiations for high-cost drugs used in Medicare under the Inflation Reduction Act, with plans to expand the scope annually [2] - Trump's previous attempts to implement a pricing plan for prescription drugs were halted by federal courts due to lawsuits from pharmaceutical companies, which claimed improper rule-making procedures [2] - The Biden administration shifted focus to legislative efforts, resulting in the passage of the Inflation Reduction Act after Trump's plan was blocked [2]