Refreshed obesity competitive landscape

Updated thoughts on this massive market following today's positive SELECT trial readout ($NVO) and Mounjaro sales beat ($LLY): Obesity refresher:
• Defined as BMI >30kg/m^2
• >750M patients globally, including ~40% of US adults --> expected to increase to 1B people / ~50% of US adults by 2030
• Linked to 1/5 US adult deaths

However, just ~2% of people (15M) are on anti-obesity medications (AOM)

Gene editing landscape

I pulled together 42 public & private companies and charted the preclinical & clinical assets of each, segmented by approach & editor

Some takeaways: In the context of therapeutics, gene editing is the insertion, deletion or replacement of sections of a patient's DNA to treat disease

The Cowen team pulled together the helpful graphic below noting the nuances between gene therapy and gene editing

Radiopharmaceuticals market map ☢️

66 companies are segmented by radioisotope and highest stage of development

Further thoughts on this emerging market below:

*After a brief hiatus, we'll be back to regular breakdowns & thought pieces here* What was once a dormant space has seen rapid growth over the past few years

Since 2018:
• 3 novel FDA-approved therapeutics
• >$1B in investor funding
• >$10B in M&A and licensing deals

With the current industry pipeline showing >60 clinical-stage and >100 preclinical assets

IBD competitive landscape & disease primer

Exploring the highly competitive space on the heels of Merck's $10.8B acquisition of Prometheus $RXDX IBD (inflammatory bowel diseases) are recurrent, chronic inflammatory conditions of the GI track

IBD is segmented by 2 distinct conditions: ulcerative colitis (UC) and Crohn's disease (CD)

Prevalence estimates vary, but there are ~2-4M IBD patients in the US & >5M worldwide

Alzheimer's Competitive Landscape 🧠

+ a deep dive into the unmet need and future of treatment: Alzheimer's disease (AD) is a progressive neurological disorder that destroys brain cells, resulting in dementia

• 7th leading cause of death (US)
• >6M patients in US, >45M WW, expected to 3x by 2060 due to aging population (~$1T/yr in US)
• >99% clinical trial failure rate

A primer on psychedelics in drug development 🍄

Digging into the emerging science, competitive landscape and convoluted path to market

Let's take a trip: First, let's define psychedelics

For this thread, they encompass classic hallucinogens & agents that produce comparable effects, as well as non-hallucinogenic derivatives

Gene therapy landscape

I pulled together 42 public companies and charted the preclinical & clinical assets of each, segmented by approach & vector

Some takeaways: The above analysis is not exhaustive: there are >350 developmental gene therapies across >115 companies

~62% are preclinical or IND-enabling. Of the remaining ~38% in the clinic / approved, the majority (~31%) are in Phase 1/2

Obesity Market Overview

A deep dive into the unmet need, competitive landscape and future of treatment: Obesity primer:

• Defined as BMI >30kg/m^2
• >750M patients globally, including ~40% of US adults --> expected to increase to 1B people / ~50% of US adults by 2030
• Linked to 1/5 US adult deaths

However, just ~2% of people (15M) are on anti-obesity medications (AOM)

Public market performance of AI-enabled drug developers (a subset of the #TechBio space)

How they've performed (and why they've struggled): Following several high-profile IPOs, shares of AI-enabled drug developers (AIDD) briefly peaked in Q1'21, before underperforming every quarter thereafter

Collective underperformance of this group:
vs. XBI: (~52%)
vs. NBI (~69%)
vs. S&P (~74%)

What happened?

My view on the top acquirers for $MDGL after yesterday's stellar data announcement in NASH

+ key late-stage pipeline assets in NASH & catalysts through 2023 & beyond: I pulled together the initial list above based on big pharma exposure to the NASH / metabolic space and then gave each a score based on these criteria:

(1) Current NASH pipeline
(2) Past BD and M&A activity in NASH
(3) Mgmt. commentary on M&A preferences
(4) Gut feeling

Snapshot of cell therapy M&A and IPO activity from 2013- 2022 YTD

+ select 2022 private financings and recent BD deals: After Gilead / Kite (2017) and Celgene / Juno (2018), M&A has been slow, aided by a robust IPO market from 2019-2021

Indexed performance for these companies trailed the XBI by (~60%) since 2021

With public markets locked up in 2022, companies have shifted their strategy

Cell therapy landscape 🧬

I pulled together 44 companies with a range of approaches & segmented assets by development phase

Let's take a deeper look Keep in mind, this is not the entire cell therapy landscape, but a good snapshot of clinical progress & key assets

With 6 approved products, >$5B in aggregate sales & a shift into earlier treatment lines, cell therapy awareness and adoption has hit a commercial inflection point