This story was originally published on Healthcare Dive. To receive daily news and insights, subscribe to our free daily Healthcare Dive newsletter. Dive Brief: Cigna’s Express Scripts could be nearing a settlement with the Federal Trade Commission in the agency’s lawsuit accusing the largest pharmacy benefit managers in the U.S. of driving up insulin prices. The FTC has suspended proceedings against Cigna’s subsidiaries — including PBM Express Scripts, health services division Evernorth and group purc ...

Transaction Overview - Aspen is selling 100% of its equity interests and intellectual property assets in Australia, New Zealand, and other Asia Pacific regions (excluding China) [35] - The gross unadjusted consideration is AUD 2.37 billion (ZAR 26.477 billion) [16, 42] - The transaction represents an EV/Normalised EBITDA (FY 2025) multiple of approximately 11x [16, 42] - Transaction and other costs are expected to be less than 5% of the net proceeds [17] Financial Performance (FY 2025) - APAC revenue was R7.792 billion, representing 18% of the Group's total revenue of R43.3 billion [12] - APAC EBITDA was R2.445 billion, representing 26% of the Group's total EBITDA of R9.324 billion [14] Strategic Rationale - The divestment aligns with the Group's strategy to unlock the underlying sum-of-the-parts value [39] - The transaction will improve balance sheet flexibility for future capital allocation [20, 39] - The company will have a heightened focus on the Group's growth drivers, including Commercial Pharma and sterile FDF manufacturing [20, 39] Anticipated Timelines - Post circular to shareholders is expected on or before 20 March 2026 [24] - Shareholder vote is scheduled for on or before 22 April 2026 [24] - Transaction completion is expected by the end of May 2026 [24]

Core Insights - Eli Lilly's CEO, Dave Ricks, criticized pharmacy benefit managers (PBMs) for inflating insulin prices, claiming they create a detrimental incentive structure that leads to high list prices while the net price remains low [1][2][5] - Ricks highlighted that the list price for Lilly's insulin reached $275, while the actual net price was around $40, indicating a significant disparity caused by PBMs profiting from the price spread [2][3] - The company's response to this issue included launching a low-priced "shadow generic" insulin, which faced pushback from PBMs, prompting the creation of LillyDirect, a direct-to-consumer platform to bypass the PBM system [3][5] Industry Context - Mark Cuban, founder of Cost Plus Drugs, echoed Ricks' sentiments, describing PBMs as having a "stranglehold" on pricing and contributing to inflated healthcare costs [4][5] - Both Ricks and Cuban's criticisms suggest a growing challenge to the PBM business model, which is perceived to inflate costs for vulnerable patients [5] Stock Performance - Eli Lilly's stock closed at $988.62, reflecting a year-to-date increase of 27.06% and a one-year increase of 20.73% [6] - The stock has shown a strong price trend across short, medium, and long terms, despite a poor value ranking [6] PBM and Pharma ETF Performance - Notable performances of PBMs and pharmaceutical ETFs include: - CVS Health Corp. with a year-to-date performance of 80.62% and one-year performance of 47.83% - Cigna Group with a year-to-date performance of -2.36% and one-year performance of -21.15% - UnitedHealth Group with a year-to-date performance of -35.10% and one-year performance of -46.73% [7] - Various pharmaceutical ETFs also showed positive year-to-date performances, with the Invesco Pharmaceuticals ETF at 22.30% and the KraneShares MSCI All China Health Care Index ETF at 37.64% [8]

Genetic Modification & Applications - Genetic modification is evolving from scary monster scenarios to a tool for solving problems by working with nature [2][3][4] - CRISPR, a gene editing mechanism, functions by substituting targeted nucleotides, similar to substituting players on a sports team [5][6][7] - The FDA has approved genetically modified crops since 1994, indicating a history of safe use [4] Industry Impact & Disease Control - The pork industry faces significant economic losses, with over $1.2 billion spent annually in the US alone to control Porcine Reproductive and Respiratory Syndrome (PRRS) [8][9] - CRISPR technology is being applied to combat infectious diseases like dengue fever by modifying mosquito genes to prevent viral infection [11][12][13] Human Health & Ethical Considerations - CRISPR offers potential treatments for genetic conditions like sickle cell anemia, caused by a single nucleotide mutation [14][15] - Modifying genes can have unintended consequences, as seen with sickle cell anemia where carriers have malaria resistance [16][17] - Gene editing tools like CRISPR require careful management to ensure ethical use, highlighted by instances of illegal experimentation [17][18]

Core Insights - Novo Nordisk A/S is recognized as one of the best bargain stocks to buy in November, with a focus on the US market to drive sales growth for its obesity drug Wegovy [1] - The Novo Nordisk Foundation, the company's top investor, has taken control of the board to enhance consumer-facing strategies and address competition from Eli Lilly and cheaper alternatives [2] Company Overview - Novo Nordisk A/S is a global leader in treating diabetes and obesity, with a significant historical focus on insulin production and a dominant market share [3] - The company's key growth segment is obesity treatment, particularly through its product Wegovy, which has shown high effectiveness in weight reduction [3] - Novo Nordisk has a highly integrated production process, from molecule development to automated filling lines, and distributes products globally to over 170 countries [3] Competitive Landscape - The primary competitor for Novo Nordisk is Eli Lilly, creating a duopoly in the modern treatment of diabetes and obesity [3] - The industry has extremely high barriers to entry due to long development times, regulatory challenges, and substantial investments required for production and distribution [3]

Core Insights - Sanofi (NASDAQ:SNY) is recognized as one of the 12 Best Widow and Orphan Stocks to Buy according to analysts, indicating significant upside potential for investors [1] Company Performance and Market Position - Berenberg has reaffirmed its Buy rating on Sanofi with a price target of EUR110.00, highlighting better returns from the company's medication pipeline [2] - Analysts estimate Sanofi's market capitalization at $111.7 billion, with stock price predictions ranging from $53 to $69, while the current trading price is $45.65 [2] Pipeline and Future Prospects - Sanofi's 2020 pipeline cohort is projected to yield a 10% return, with potential for significant growth if peak sales of key drugs like amlitelimab and frexalimab double, or if duvakitug enters Phase 3 [3] Pricing Strategy and Patient Access - Sanofi announced a new initiative to cap the cost of any insulin product at $35 per month for U.S. patients with a valid prescription, regardless of insurance status, which aims to enhance patient access [4] - This pricing strategy reflects Sanofi's commitment to expanding its pipeline momentum and improving accessibility for patients in the United States [4] Company Overview - Sanofi is engaged in researching, developing, manufacturing, and marketing pharmaceutical solutions globally, with a focus on various therapeutic areas including immunology, neurology, oncology, rare diseases, and vaccines [5]

Core Insights - Walmart is expanding its delivery services to include chilled and reconstituted prescription medications, which is expected to sustain its 14% year-to-date stock performance [1] - This initiative positions Walmart as the first major national retailer to offer both cold-chain pharmaceutical delivery and basic grocery needs in a single order, impacting both local communities and the stock market [2] - The integration of high-value medications into Walmart's logistics aims to enhance customer loyalty through Walmart+ memberships and create competitive pressure on rivals like CVS and Amazon Pharmacy [3] Company Strategy - Walmart's pharmacy generates over 30% of its revenue from refrigerated prescriptions, and since launching its delivery service, it has completed over 4 million pharmacy deliveries [2][4] - The company has been preparing for this expansion for over a year, testing pharmacy delivery in 2024 and rolling it out to all locations by early 2025 [4] - The addition of cooled medications significantly broadens Walmart's market reach, as these products account for nearly one-third of pharmacy sales [5] Operational Capabilities - Walmart's cold-chain infrastructure includes insulated packaging and real-time monitoring, ensuring secure delivery of medications [6] - An electronic signature is required upon delivery, providing customers with assurance similar to that of a traditional pharmacy [6] Customer Engagement - The new delivery service is integrated into Walmart+, offering free delivery for members while non-members incur delivery fees, incentivizing more customers to join the loyalty program [7]

Group 1 - Walmart is expanding its pharmacy delivery services to include refrigerated medications such as insulin, weight loss medications like Ozempic, and specific hormone therapies [2] - The delivery of these medications will be conducted in special insulated packages [2] - Medications will be delivered in as little as 30 minutes [2]

Core Insights - Eli Lilly is actively engaging with the administration regarding policy-related uncertainties in the pharmaceutical sector, particularly following the first Most Favored Nation (MFN) executive order [3][4] - The company has reported positive conversations with the administration, focusing on reducing patient out-of-pocket costs in the U.S., citing past successes such as capping insulin prices at $35 [4] Company Engagement - Lucas E. Montarce, CFO of Eli Lilly, participated in the Goldman Sachs 46th Annual Global Healthcare Conference, indicating the company's commitment to addressing industry challenges [1][2] - The company is prepared to discuss its strategies and experiences in managing pricing and patient access during industry conferences [3][4]

Summary of Cencora (COR) 2025 Conference Call Company Overview - **Company**: Cencora (COR) - **Date of Conference**: May 13, 2025 - **Key Speakers**: Bob Mach (CEO), Jim Cleary (EVP and CFO), Bennett Murphy (SVP and Head of IR and Treasury) Industry Insights - **Industry**: Specialty Pharmaceuticals and Healthcare Distribution Key Points and Arguments Business Model and Pricing - The company has evolved its business model over the past decade, moving from a reliance on generics to a more diversified approach that includes fixed fee contracts and specialty medications [2][10] - The impact of potential changes to drug pricing, such as the MFN executive order, is uncertain, but the company believes it will not harm community providers or patient access [4][5][9] - Cencora has been proactive in Washington, advocating for providers and patient access to pharmaceuticals, which positions them favorably in discussions about pricing changes [6][7][8] Financial Performance - Cencora has experienced strong earnings growth, with a 23% increase in US operating income in the most recent quarter [18] - The company has outperformed its guidance multiple times this fiscal year, driven by strong utilization trends and sales of specialty products [15][17] - The company expects continued strong performance in 2025, with no significant changes anticipated compared to 2024 [16][20] Specialty and Health Systems - Cencora is well-positioned in the specialty market, particularly within health systems, which are increasingly setting up their own pharmacies [21][22] - The company provides consulting services to health systems to help them expand their pharmacy services, including specialty and infusion pharmacies [27][28] Generics and Inventory Management - Cencora maintains disciplined inventory levels and focuses on strong product access for customers, particularly in the generics market [31][32][33] - The company is cautious about potential tariffs on pharmaceuticals but is not significantly altering its inventory strategy [29][30] Operating Expenses and Growth Strategy - The company emphasizes operating leverage, aiming for operating expenses to grow slower than gross profit [36][37] - Cencora is focused on productivity initiatives to enhance efficiency as it continues to grow [39] Market Opportunities - Cencora is targeting organic growth in oncology and retina specialties, with a focus on attracting smaller physician practices [41][42] - The company is optimistic about the adoption of biosimilars in the physician space, which is already strong [49][50] Capital Deployment - Cencora plans to maintain balanced capital deployment, with approximately $600 million allocated for capital expenditures this year, primarily for technology and infrastructure [52][53] - The company has a strategy for opportunistic share repurchases and aims to grow dividends at a sustainable rate [54][55] Future Outlook - The leadership team is excited about the growth potential in specialty pharmaceuticals, driven by innovation and technology [56][57] - The focus on customer centricity and active engagement with stakeholders is expected to sustain the company's momentum [58][59] Additional Important Insights - The company has a long-term partnership with physicians in oncology and retina, which enhances its competitive position [45][46] - Cencora's unique understanding of the pharmaceutical supply chain allows it to advocate effectively for its stakeholders [7][8] This summary captures the essential insights and strategic directions discussed during the conference call, highlighting Cencora's positioning within the specialty pharmaceuticals industry and its proactive approach to market challenges.