21世纪经济报道记者季媛媛 头部跨国药企在2025年经历了天差地别的命运分化。 从财报数据中就可看出其中的端倪。根据财报显示，诺和诺德公布的2025年第三季度业绩报告显示，第 三季度总营收749.76亿丹麦克朗（约112.76亿美元），同比增长11%；2025年前三季度总营收达2299.20 亿丹麦克朗（约345.8亿美元），同比增长15%。司美格鲁肽系列产品持续领跑业绩，三大品牌销售额 表现亮眼：Ozempic（降糖版）：952.64亿丹麦克朗（约143.28亿美元），增长13%；Rybelsus（口服片 剂）：167.90亿丹麦克朗（约25.25亿美元），增长5%；Wegovy（减肥版）：572.42亿丹麦克朗（约 86.09亿美元），大幅增长54%。三大品牌销售额总计约1692.96亿丹麦克朗（约254.62亿美元），同比 增长24%，贡献了公司大部分营收。其销售业绩现已高于替尔泊肽（248.37亿美元）与帕博利珠单抗 （233.03亿美元）。 相比之下，尽管默沙东拥有"网红"产品PD - 1单抗K药（Keytruda，帕博利珠单抗）以及九价HPV疫苗， 但其2025年前三个季度制药业务收入为432.9 ...

Core Insights - The pharmaceutical industry is experiencing significant performance divergence among major multinational companies in 2025, with some achieving remarkable growth while others face substantial declines [1][4][6]. Financial Performance - Novo Nordisk reported Q3 2025 revenues of 74.976 billion Danish Krone (approximately $11.276 billion), a year-on-year increase of 11%, with total revenues for the first three quarters reaching 229.92 billion Danish Krone (approximately $34.58 billion), up 15% [1]. - Merck's pharmaceutical business revenue for the first three quarters of 2025 was $43.299 billion, with a 68% year-on-year decline in revenue from China, dropping to $1.452 billion [2]. - Eli Lilly achieved a Q3 2025 revenue of $17.6 billion, a 54% increase from $11.439 billion in the same period last year, with total revenues for the first three quarters reaching $45.887 billion, up 46% [3]. - Pfizer's Q3 2025 total revenue was $16.654 billion, a 6% decrease from $17.702 billion year-on-year, with a 55% drop in revenue from its COVID-19 oral drug Paxlovid [4]. Strategic Adjustments - Major pharmaceutical companies are actively seeking solutions to address strategic challenges, including layoffs and business divestitures, with 190 layoffs reported in the biopharmaceutical sector in the first three quarters of 2025 [2][9]. - Companies like Merck and Novo Nordisk are implementing significant cost-cutting measures, with Merck aiming to save $3 billion by 2027 and Novo Nordisk targeting an annual cost saving of 8 billion Danish Krone [9]. - The trend of divesting mature assets is becoming common, with investment firms stepping in as buyers, indicating a shift in the operational landscape of the pharmaceutical industry in China [7][8]. Market Dynamics - The Chinese market is no longer a guaranteed profit zone for multinational pharmaceutical companies, with significant performance disparities emerging among leading firms [5][12]. - The ongoing "patent cliff" is a critical concern, with many companies facing over 20% revenue exposure to patent expirations in the next three years, impacting their financial stability [4][5]. - The competition in the pharmaceutical sector is intensifying, necessitating companies to adapt quickly to local market policies and innovate their product pipelines to maintain growth [6][12]. Future Outlook - The future of multinational pharmaceutical companies will heavily rely on their innovation capabilities, local market strategies, and management of patent expirations [12][15]. - Companies that successfully transition to innovation-driven models and establish strong positions in emerging therapeutic areas are likely to thrive, while those unable to adapt may face ongoing growth pressures [12][15]. - The restructuring of global pharmaceutical strategies is expected to accelerate, focusing on both downsizing and investing in innovative fields, such as gene and cell therapies [9][10].

科尔尼医疗与生命科学团队 近期在《Nature Reviews Drug Discovery》发表论文，分析了自身免疫疾 病领域的发展趋势。过去几十年，通过 细胞因子靶向 实现的 免疫调节 进展推动了治疗创新，据IQVIA 数据，全球自身免疫药物市场在2023年已达到1560亿美元，年复合增长率为15%。这个时代的标志是 肿瘤坏死因子α抑制剂的成功 （现已成为许多疾病的标准治疗）以及 白细胞抑制剂 的出现。然而，推 动此轮增长的明星产品，如修美乐（UMIRA (anti-TNF)）和喜达诺（STELARA (anti-IL-12/23)），如今 面临生物类似药的竞争，而其他领先产品，如达必妥（DUPIXENT (IL-4/13)）和喜开瑞（SKYRIZI (IL- 23)），则在各自适应症中设定了很高的"疗效天花板"。下一个突破性创新时代将与今天大不相同。 未来三到五年，我们预计市场将继续增长，主要驱动力是JAK抑制剂和IL抑制剂在多疾病领域的上市， 以及首创药物（尤其是TNFα以外的TNF靶点）的涌现——这些都将试图提高自身免疫疾病的疗效标 准。 本文探讨自身免疫疾病的研发技术趋势，并分析其影响。 自身免疫 ...

Core Viewpoint - AbbVie has reached a settlement with all involved generic drug companies regarding the lawsuits related to the planned launch of a generic version of Rinvoq, a key immunotherapy product in AbbVie's portfolio [1] Group 1: Legal Developments - AbbVie announced a settlement that resolves litigation against generic drug companies seeking to launch a non-patented version of Rinvoq [1] - The settlement and licensing agreement will prevent generic versions of Rinvoq tablets from entering the U.S. market until April 2037 [1] Group 2: Product Positioning - AbbVie positions Rinvoq and its sister drug Skyrizi as potential replacements for Humira, which lost its U.S. market exclusivity in 2023 [1] - Rinvoq's net sales reached $2.7 billion in the first half of 2025, reflecting a year-over-year growth of approximately 53% [1] Group 3: Market Comparison - In contrast, Humira's sales in the U.S. market declined by about 63% during the same period [1]

Core Viewpoint - Johnson & Johnson (JNJ.US) has decided to terminate the joint development project of its experimental antibody drug, nipocalimab, with anti-tumor necrosis factor alpha (anti-TNFα) therapy for the treatment of rheumatoid arthritis (RA) due to the results of its Phase 2a DAISY proof-of-concept study, which showed no significant clinical benefits over the use of anti-TNFα therapy alone [1] Group 1 - The combination therapy of nipocalimab and anti-TNFα did not demonstrate significant clinical benefits in RA patients compared to anti-TNFα therapy alone, despite no new safety issues being reported [1] - Johnson & Johnson has decided not to advance the clinical development of this combination therapy in the RA treatment area based on the study findings [1] - Nipocalimab was previously considered a key research project in Johnson & Johnson's rheumatology portfolio, with projected peak annual sales exceeding $5 billion [1] Group 2 - The setback highlights the high-risk nature of innovative drug development, particularly in the competitive field of autoimmune disease treatments [1] - Humira, AbbVie's blockbuster drug, generated nearly $21 billion in sales in 2021 but is facing sales pressure starting in 2023 due to the introduction of biosimilars by U.S. companies [1]

Core Insights - The global pharmaceutical sales ranking for the top 50 drugs has been revealed, with Novo Nordisk's semaglutide surpassing Merck's Keytruda to become the new sales champion, achieving over $16.6 billion in sales [1][3] - Eli Lilly's tirzepatide shows significant growth potential with a sales increase of 121.3%, reaching nearly $15 billion [1][2] - The entry of domestic innovative drugs into the ranking marks a notable shift in the competitive landscape [1] Group 1: Top Selling Drugs - Semaglutide, including Ozempic, Rybelsus, and Wegovy, generated sales of $16.632 billion, with a year-on-year growth of 29.8% [3][4] - Tirzepatide achieved sales of $14.734 billion, with a remarkable growth rate of 121.3% [3][8] - Dulaglutide, another Eli Lilly product, saw a decline in sales, highlighting the competitive pressures in the market [3][4] Group 2: Vaccine Sales Decline - Three vaccine products in the top 50 experienced sales declines, despite a favorable competitive landscape [4][5] - Gardasil 9, a nine-valent HPV vaccine, saw a nearly 50% drop in revenue [5][6] - The decline in vaccine sales is attributed to reduced government subsidies and market saturation [6][7] Group 3: Emerging Drugs and Growth - Over 70% of drugs in the ranking maintained positive sales growth, with only seven drugs exceeding a 30% growth rate [8] - Enzalutamide, approved for 13 years, continues to show over 30% growth, with sales projected to reach $4.6 billion in 2022 [9][10] - The competitive landscape for enzalutamide is expected to intensify as its core patent expires in 2026 [10]

Core Insights - AbbVie is poised to fill the $20 billion gap left by Humira with its new immunology drugs Skyrizi and Rinvoq, which are expected to generate over $25 billion in combined sales this year, significantly exceeding initial forecasts [1][4] - Skyrizi's sales reached $4.4 billion in Q2, showing a year-on-year growth of 61.8%, while Rinvoq generated $2 billion, indicating strong momentum for both products [4][5] - The rapid growth trajectory of Skyrizi suggests it could surpass $20 billion in sales by 2026, establishing it as a potential new leader in the immunology market [2][4] Sales Performance - Skyrizi's global sales are projected to exceed $10 billion in 2024, driven by its expanding indications in inflammatory bowel disease (IBD) and dermatological conditions, with a year-on-year growth of 50.9% [3][4] - AbbVie has raised Skyrizi's 2025 sales forecast to $17.1 billion, a 46% increase from the previous year, with $4 billion of this growth attributed to IBD indications [4][6] - Rinvoq is also expected to contribute significantly, with a clear three-phase strategy targeting various indications, including rheumatoid arthritis and IBD [5][6] Competitive Landscape - The immunology market is becoming increasingly competitive, with major players like Johnson & Johnson and Eli Lilly entering the IL-23 target space, raising concerns about market share and growth sustainability [7][8] - AbbVie maintains confidence in Skyrizi's market position, citing its increasing share among treated patients and its differentiated advantages over competitors [7][8] - The rapid pace of innovation in the immunology sector is compressing the window for new entrants, making it crucial for companies to establish strong clinical differentiation and market presence [10][11] Future Outlook - The transition from Humira to Skyrizi and Rinvoq exemplifies the need for continuous innovation in the pharmaceutical industry, as the market dynamics shift rapidly [10][11] - AbbVie is entering a new phase with its immunology portfolio, having no major patent expirations in the next decade, providing it with more strategic options [4][10] - The success of Skyrizi and Rinvoq highlights the importance of robust clinical data and broad indications in driving growth in the competitive landscape of immunology [6][9]

Core Viewpoint - The essence of innovative drug investment is a "high risk, high return" technological gamble, with value realization highly concentrated in the critical window of "emergence of potential blockbuster drugs → successful commercialization during patent period" [1] Group 1: Industry Characteristics and Valuation Paradox - The success rate of a drug from clinical trials to approval is only about 10%, with an average of 2 out of 10 new drugs recovering their R&D investment since 1988 [2] - The industry is driven by blockbuster drugs, as most approved drugs fail to recover costs, leading to a "fat tail" profit distribution where a few blockbuster drugs support overall industry profitability [3] - The overall R&D return rate in the industry is close to zero, with a clinical failure rate of up to 90%, which significantly impacts company valuations [5] Group 2: Platform Companies and R&D Efficiency - The long-term trend in industry R&D efficiency, measured by the number of FDA-approved drugs per billion dollars spent, has been declining, a phenomenon referred to as "Eroom's Law" [8] - Even leading companies like HengRui Medicine face uncertainties regarding the continuous output of blockbuster drugs despite recent successes in ADC/dual antibody transactions [9] Group 3: FIC vs. BIC Debate - Historical data shows that the proportion of first-in-class (FIC) drugs among blockbusters has remained stable at around 30%, with a slight increase in recent years [11][13] - The analysis indicates that being a FIC does not significantly enhance the likelihood of a drug becoming a blockbuster, with most value in the industry derived from best-in-class (BIC) drugs rather than FICs [14] Group 4: Redefining Value Investment - Traditional value investment principles do not apply well to innovative drug companies due to low R&D return rates and high failure rates [15] - The focus should be on phase-specific value creation, particularly during the validation and commercialization of potential blockbuster drugs [15] Group 5: Investment Decision Framework - Investment should focus on the value verification and release cycle surrounding potential blockbuster drugs [16] - Early-stage investments should target companies with disruptive technology platforms or unique scientific insights, especially when their platform value is not fully recognized [17][18] - Key value inflection points include critical clinical phases and successful data readouts, which can significantly enhance success probabilities [21][22] Group 6: Current Market Dynamics - The current innovative drug bull market is driven by active BD transactions and the increasing share of domestic companies in global BD deals [25][28] - Domestic regulatory reforms have significantly shortened new drug review times, enhancing the value chain of Chinese biopharmaceutical companies [25] Group 7: Summary and Recommendations - Innovative drug investment is about capturing phase-specific value explosions around blockbuster drugs, rather than adhering to traditional "buy and hold" strategies [29] - Investors should focus on key catalysts and balance probability with potential returns, utilizing DCF models to assess drug value while understanding market expectations [29][30] - Continuous tracking of pipeline progress, competitive landscape, and regulatory dynamics is essential due to the fast-changing nature of the industry [32]

Core Viewpoint - The investment essence of the innovative drug industry is a "high risk, high return" technology game, with value realization highly concentrated in the window of "emergence of potential blockbuster drugs → successful commercialization during patent period" [2] Group 1: Nature of Innovative Drug Investment - Innovative drug investment combines "stage-based value investment" and "probability game" due to the industry's unique characteristics [3] - The overall R&D return rate in the industry is close to zero, with a 90% failure rate in clinical stages, leading to a valuation paradox [3] - The value of companies is highly dependent on single blockbuster drugs, and without replacement products post-patent cliff, valuations can collapse [3] Group 2: Redefining Value Investment - Traditional value investment standards are difficult to apply to pure innovative drug companies due to low R&D returns and high failure rates [4] - Value creation in innovative drug companies is concentrated in the window of "potential blockbuster validation → approval → successful commercialization" [4] - The core of evaluating a drug company is the discounted cash flow of existing products and future pipelines, with blockbuster potential being a key variable [4] Group 3: Probability Game - Drug development is a high-risk process, with early pipeline value being low but exponential increases in value upon successful key clinical trials [6] - Excellent platforms and management can significantly improve success probabilities and efficiencies, although they do not guarantee success [6] - The role of platforms includes improving success rates, increasing the number of attempts, and maximizing the value of successful projects [6] Group 4: Investment Decision Framework - Investment decisions should revolve around the value verification and release cycle of potential blockbuster drugs [8] - Early-stage investments focus on companies with disruptive technology platforms or unique scientific insights, with high risk but potentially huge returns [9] - Key value inflection points occur when core pipelines enter critical clinical stages, significantly increasing success probabilities [11] Group 5: Timing and Exit Strategies - Timing is crucial; knowing when to invest is often more important than which company to invest in [19] - Investors should exit when core value drivers are disproven, growth expectations peak, or when nearing patent cliffs [17] - Continuous tracking of pipeline progress, competitive landscape, clinical data, regulatory dynamics, and sales performance is essential [19] Group 6: Final Conclusion - Innovative drug investment focuses on identifying and investing in companies experiencing non-linear value growth driven by breakthrough drugs [20] - Successful investment requires scientific insight, business judgment, probability thinking, and strict timing discipline [20]

Summary of Conference Call Notes Industry Overview - The conference call discusses the pharmaceutical industry, particularly focusing on the implications of the Trump administration's proposed "Most Favored Nation" (MFN) drug pricing policy on the global pharmaceutical market and U.S. healthcare spending [1][2][3]. Key Points and Arguments - **Most Favored Nation Policy**: The Trump administration has reintroduced the MFN policy aimed at reducing high drug prices in Medicare Part B by referencing prices from other high-income OECD countries. However, the specifics of the policy remain unclear, and its implementation is uncertain [2][10][12]. - **U.S. Healthcare Spending**: In 2023, U.S. healthcare spending reached $4.87 trillion, accounting for 17.6% of GDP. Prescription drug spending constituted approximately $449.7 billion, or 9.2% of total healthcare expenditures [3][4]. - **Drug Price Disparities**: U.S. brand-name prescription drug prices are, on average, 422% higher than those in other developed countries. Even after accounting for rebates, U.S. drug prices remain 308% higher [5]. - **Complex Pricing System**: The U.S. drug pricing system involves multiple stakeholders, including manufacturers, wholesalers, retailers, and insurers, leading to a complex negotiation process that affects final consumer prices [6][9]. - **WAC vs. ASP**: The Wholesale Acquisition Cost (WAC) and Average Sales Price (ASP) typically differ by 20%-30%. WAC tends to increase over time, but ASP may not rise correspondingly due to rebates, resulting in final prices being 40%-50% higher than WAC [7]. - **AbbVie Pricing Strategy**: AbbVie employs a high WAC and rebate strategy, maintaining a strong market share even after patent expiration by providing significant discounts to Pharmacy Benefit Managers (PBMs) [8]. - **Role of Intermediaries**: Intermediaries like PBMs and insurers dominate the pricing and distribution process, with non-manufacturer income share increasing from 33.2% in 2013 to 50.5% in 2020, surpassing manufacturer income [9]. Additional Important Insights - **Impact on Chinese Pharmaceutical Companies**: The MFN policy may lead to increased demand for innovative drug development in China as multinational companies may reduce R&D budgets and focus on cost control. Chinese companies are encouraged to develop competitive, differentiated product pipelines [3][15]. - **Long-term Strategic Shifts**: If the MFN policy is implemented, it could lead to a shift in global innovation strategies for pharmaceutical companies, with a potential decrease in investment in high-risk, long-term R&D projects aimed at the U.S. market [16]. - **Challenges of Implementation**: The MFN policy faces challenges due to the lack of clear implementation guidelines and the need for bipartisan support for legislative changes, which may limit its short-term impact [13][14]. This summary encapsulates the critical aspects of the conference call, highlighting the implications of the proposed drug pricing policy on the pharmaceutical industry and the broader healthcare landscape.