瑞信-美股-医疗保健行业-全球医疗业：华盛顿的COVID-19疫情探讨-2020.3.27-27页.pdf

Global Healthcare Transcript from Expert Call with Ethan Siegal to discuss ongoing COVID-19 landscape out of Washington D.C.Healthcare|Conference Call We hosted an expert call this week with Ethan Siegal of the Washington Exchange to discuss the latest developments from Washington on the COVID-19 situation.As a background,The Washington Exchange provides insight regarding public policy issues and their impact on the capital markets.We have included the full transcript of the call in this document.A replay of the call is available:(855)859-2056/(404)537-3406;ID:6195893.27 March 2020 Equity Research Americas|United States DISCLOSURE APPENDIX AT THE BACK OF THIS REPORT CONTAINS IMPORTANT DISCLOSURES,ANALYST CERTIFICATIONS,LEGAL ENTITY DISCLOSURE AND THE STATUS OF NON-US ANALYSTS.US Disclosure:Credit Suisse does and seeks to do business with companies covered in its research reports.As a result,investors should be aware that the Firm may have a conflict of interest that could affect the objectivity of this report.Investors should consider this report as only a single factor in making their investment decision.Research Analysts Evan Seigerman 212 325 4463 evan.seigermancredit- European Pharma Team 44 207 888 0304 creditsuisse.pharmateamcredit- A.J.Rice 212 325 8134 aj.ricecredit- 每日免费获取报告1、每日微信群内分享7+最新重磅报告；2、每日分享当日华尔街日报、金融时报；3、每周分享经济学人4、行研报告均为公开版，权利归原作者所有，起点财经仅分发做内部学习。扫一扫二维码关注公号回复：研究报告加入“起点财经”微信群。27 March 2020 Global Healthcare 2 p CREDIT SUISSE SECURITIES,LLC Moderator:Evan Seigerman March 27,2020 10:00 a.m.ET OPERATOR:This is Conference#:6195893 Operator:Ladies and gentlemen,thank you for standing by,and welcome to the Ongoing DC landscape response to COVID-19.At this time,all participants are in a listen-only mode.After the speakers remarks,there will be a question and answer session.To ask a question during the session,you will need to press“star,”“1”on your telephone.If you would like to withdraw your question,press the“pound”key.Please be advised that todays conference is being recorded.If you require further assistance,please press“star,”“0.”I would now like to hand the conference over to you speaker today,Evan Seigerman.Thank you.You may begin.Evan Seigerman:Thank you,Operator,and thank you,everyone,for joining us today.We are here today with Ethan Siegal from the Washington Exchange to discuss the ongoing DC response to the current COVID-19 pandemic.Well be covering various initiatives at FDA,some policy thoughts,and of course the recent CARES Act,which is the relief bill that was recently passed by the Senate.On the call today,I have my colleagues,AJ Rice,our Managing Director and Healthcare Facilities Senior Analyst,Jo Walton from the European Pharma Team who will also be asking you some questions,and of course Ethan Siegal from the Washington Exchange.Ethan,are you there?Ethan Siegal:Yes,good morning.27 March 2020 Global Healthcare 3 Evan Seigerman:Great.Good morning.Just before we get started,I want to read a quick disclaimer and we can jump right in.We are publishing equity research analysts.We may use the information you provide in research.With me on the phone are members of the investor community.They may use the information you provide when deciding to whether to buy or sell stocks or other investments.We do not want material non-public information or information that is subject to a confidentiality obligation.We do not want to speak with you if this will violate your employers policies or confidentiality obligations you owe to anyone else.Do you want to proceed with the consultation on that basis?Ethan Siegal:Yes.Evan Seigerman:Perfect.Well lets just kick it right off,Ethan.Why dont you give us a kind of state of where we are?We can talk about SBA and the recent CARES Act.I know you has some initial opening comments.Ethan Siegal:Thank you,Evan and Jo and AJ,and good morning to everyone on the call.So I do have some brief opening remarks about the Washington pharma landscape under the black rhino of the COVID outbreak,and Im going to start with a couple of stories in a moment.First and foremost because the FDA has been the single-best Washington pharma story for years even with drug pricing threats in the background,I think theres going to be a lot of pressure in the next couple of days on Stephen Hahn to make some sort of announcement or provide some sort of guidance with regard to dates and timelines and approvals for new drugs due to the focus on COVID and the impact overall impact on clinical trials just as the USPTO made a series of announcement regarding the impact of COVID-19 on normal business operations.So I think he were bending the odds(that he)does say something to give the industry some guidance.He obviously Stephen Hahn remains under pressure from President Trump on therapeutics approvals as President Trumps political game plan is to get therapeutics into the production pipeline and distribute it to patients ASAP and reopen as much of the country as possible by mid-April(arrest)the freezing up of the country.Thats his reelection game 27 March 2020 Global Healthcare 4 plan.He is very obvious and clear about it,and we expect him to only ramp up the pressure on both those angles.Second,given all the discussion and concerns about the pricing and reimbursements and co-pays for COVID therapeutics and eventually a vaccine,I thought the NIHs Anthony Fauci yesterday made an important statement at the White House Coronavirus Task Force press briefing when he said that if the early data on the Moderna vaccine looks promising,quote,“Im going to try to find somebody that is going to make it,”close quotes,before the phase 2 trials begin.I think this reflects the reality that from top to bottom,meaning scientists who(tend not to be)political,the scientists and the doctors to the politicians themselves,the Trump administration,Democrats on Capitol Hill all recognize that COVID-related drugs have to affordable or free,and we expect this to make its way through all of the ancillary discussions about emergency use authorization and exactly how plans are going to deal with these drugs and,of course,internally within the companies themselves with regard to compulsory licensing or voluntary agreements where that comes into play.Third,the CARES Act as far as were concerned is a done deal.All the noise about it being held up in the House is,as far as were concerned,just typical House ego and politics.Could it get delayed by a day because unlike Speaker Pelosis desire to pass the bill on a voice vote certainly one or more Republicans or Democrats could reject to that,require a roll call vote,and most of the 435 members of the House have been back in their districts for 10 days.They all got the notice last night that a roll call vote might happen and that those who could from a health perspective travel back to Washington should get back here by noon time today.So we still think the odds favor that the bill gets passed today and Trump either signs it tonight or sometime tomorrow,but the House vote could get delayed till tomorrow.But the bottom line is the CARES Act is a done deal.In fact,Washington is moving beyond the CARES Act.The bill does include$11 billion for vaccine and therapeutics and diagnostics.$3.5 billion of that is dedicated to construction,27 March 2020 Global Healthcare 5 manufacturing,and the purchase of vaccines and therapeutics.The bill does requires that Medicare Part B beneficiaries and people with private insurance will have access without cost sharing to any COVID-19 vaccine.This does not apply to Part D.And most of the sidebar incremental things that some of the pharma companies or pharma itself was lobbying for did not make it into the bill because for the most part on the healthcare side not so much necessarily on the tax side this is a fairly clean bill in terms of goodies.Going forward,the first issue is going to be the administration of the bill.Steve Mnuchin,the Treasury Secretary,two days ago made some comments about getting the money out the door fast.So on the rebate for people,getting the money to small businesses,and talking about the$450 billion that the Treasury and the Fed are going to work on that translates into about$4.5 trillion for loans.But the negative in what Mnuchin said in general was that the checks may not go out to individuals for three weeks,and the small business facility loans may not be up and running till a week from today.And this relates specifically to say the hospitals for instance and their money.The hospitals are still looking for some sort of guidance out of HHS and Alex Azar because the legislations statutory language gives Azar a pretty wide discretion as to how the$100 billion for hospitals is spent.Rural hospitals are cash poor,and they have already been banging on Azar to get some guidance out there,to get the money out the door.So the biggest storyline really which surrounds the CARES Act at this point now is how fast can the money get out the door for all the various sectors,and will this be enough money?$2 trillion or$2.2 trillion,however this bill is eventually(scored),it is a huge amount of money and it makes you sit up and take notice,but it is still a Band-Aid bill.Its not a stimulus bill.This is going to cover problems that already exist and doesnt deal with the aftermath of when the COVID virus becomes an issue that is on the down slope,and nobody knows where that is.This bill was put together with the we think and were not scientists or doctors rosy scenario that by mid to late April the virus is going to be on 27 March 2020 Global Healthcare 6 a downward slope.Im not so sure thats true.A lot of people in the scientific community arent so sure thats true.So its unclear whether the next phase of the CARES Act is going to go smoothly to not,and thats the administration.And that has a lot to do in turn in our view with the psyche of the country and how they view whats going on in Washington,how efficient it is to kick out the money.The discussion are already starting for a phase four bill.The administration is open to additional monies.The target timeline is to do a phase four assistance bill around May 1.Trump,of course,is open to a blank check.Hell spend as much money as needed because he sees it as helpful to his reelection as hes not a deficit or a debt guy of any concern.The Democrats,of course,would like to spend more money,but there is resistance on the part of both Senate and House Republicans for a phase four bill that it just cant be the kind of$2 trillion price tag that this bill was,although there are a lot of people in the economics world who believe theres probably another$2 trillion will be needed because the economic recovery out of the eventual down slope of the virus is going to be slow,and there needs to be more than just a replenishment of monies to the hospitals and the medical supply chain and into individuals pockets and to small business,but there may be a need for actual stimulus.So the phase four bill is going to be slowly discussed in the back rooms.You dont need the Congress House or the Senate to be in session to do this,and in fact the Senate is out till April 20 now,and the House after todays vote is going to be back in their districts.The phase three CARES Act really was put together by about 30 people.As long as they talked to their back benchers along the way,thats how the next bill will be done also.The Republicans I think are looking to keep it down the$500 billion level.I think the Democrats are looking for the$2 trillion and the Trump White House is probably somewhere in-between.We do think the bill will include a replenishment of money for the hospitals and for medical 27 March 2020 Global Healthcare 7 supplies on the healthcare side.Price figure isnt out there yet but it could be in our view clearly another$100 billion for the hospitals.AJ Rice:Great.Sorry,why dont we jump in and kind of go through some Q&A.I know we want to discuss the FDA response.You had mentioned that there is probably mounting pressure for the FDA to approve something.Weve looked at a lot of the data kind of were really early with regard to clinical trials for something like death severe or some of the work that say Regenerons working on.But I guess whats the current political appetite and kind of what do you think whats the FDA response to this kind of near-term over the next two months and then over the next year?Ethan Siegal:Well,the pressure is on Hahn and(Woodcock)to excuse me,check the science and get something on the market as soon as possible.And I think this is daily pressure both privately from the Trump administration on Stephen Hahn.And I think its something that except for yesterdays press conference for about six days in a row Trump has promoted therapeutic drugs that are already on the market that could be used to treat COVID.So,I think that the timeline is probably much shorter than the two months you mentioned because of the political pressure on Hahn.Now Hahn as recently as was either yesterday or the day before tweeted out that he will always keep science first and foremost with regard to the decision making at the FDA.But the political reality is that hes a new guy,he really doesnt know the ropes,and hes Trump appointee and hes under a lot of pressure from the White House to do something quickly as opposed to the internal back and forth within the FDA which is to follow the science.AJ Rice:Excellent.And then just touching on we just we talked earlier this week.Whats the view on pricing of these drugs?Kind of what do you think is politically acceptable?You had mentioned something about no co-pay but kind of whats the broader perspective there when some of these are hopefully ultimately approved for use.27 March 2020 Global Healthcare 8 Ethan Siegal:Well,I dont think theres a firm conclusion on this.There is a sort of an overview which is that all of the players understand especially the industry which has concern that this is a one off.Its not a trend setter.Were going to go back to normal business after this is over.And so,any price points that we give in on we will not be held to down the road,it will not affect R&D,it will not affect IT.And so I think theres a general view on the part of the industry as a whole.That isnt necessarily true on a company by company basis.And as you know in the past some companies have been tone deaf to these types of issues,many others havent been.On the pure political side,there is pressure bubbling up from the Congress itself,mostly Democrats but some Republicans on the administration and the federal agencies with regard to the fact that these therapeutic drugs in the backseat eventually have to be free to patients.And that some sort of mechanism has to be worked out from the administration down to the MCOs and the drug companies that there is that theres got to be some sort of in a sense pro bono going on here at the counter and via plans.And so,I expect some sort of dea