Novartis AG CEO Vas Narasimhan said the COVID-19 pandemic has impacted sales of its most complex medicines, including nuclear therapy Lutathera, gene therapy Zolgensma and Kymriah, a treatment that harnesses the body's immune system to fight cancer cells — all of which require hospital administration.
There has been some slowdown in terms of hospital visits, Narasimhan said, notably in the U.S. for Kymriah, the first-ever chimeric antigen receptor T cell therapy to receive regulatory approval for a type of blood cancer. The CAR-T medicine is administered in a hospital via a complex process that involves the collection of patients' white blood cells through a specialized blood filtration system before they are re-engineered and re-infused.
"Any medicine that involves a patient ... placed in hospital or monitored in hospital for a period of time — so both with radioligand therapy [Lutathera] and in Kymriah's case — there is some slowdown in hospital visits that we're certainly seeing," the CEO said on a call with reporters following the Basel, Switzerland-based company's first-quarter results.
Sales of one-time gene therapy Zolgensma came in at $170 million, lower than consensus forecasts of $200 million and shy of Jefferies' $207 million estimate. Kymriah sales were $93 million, shy of the $97 million forecast by Vontobel and consensus,
Still, Novartis reiterated its guidance for the full year, assuming healthcare systems return to near normal in the second quarter,
"Overall results are a minor positive," said Jefferies analyst Peter Welford.
Narasimhan has pledged that nuclear and other advanced therapies will account for 20% of Novartis' sales by 2023.
In the April 28 earnings call, the CEO said the use of digital technologies, notably the Sense platform — a standardized dashboard that reports on all of Novartis' clinical trials around the world in real-time — has helped the company to manage and reallocate some clinical trials to Asia, where there has been minimal impact. In the U.K., enrollment in the ORION-4 trial of inclisiran, a late-stage treatment to manage cholesterol levels, has been paused due to the impact of the pandemic on the National Health Service, but Narasimhan said he was hopeful it will restart "in the coming quarters" and there will be no impact on the current study.
COVID-19 investment and trials
As part of the COVID-19 efforts being undertaken by the Swiss group — which divested its vaccines business to GlaxoSmithKline PLC in 2015 — Novartis is conducting two dozen investigator-initiated trials, investing more than $40 million in up to 60 projects around the world to strengthen medical infrastructure and provide onsite support, and spearheading alliances, including with the Bill & Melinda Gates Foundation and 12 large pharmaceutical companies.
Addressing the European vaccine capacity constraints raised by Sanofi CEO Paul Hudson last week, Narasimhan said he is optimistic that collaborations will result in the creation of extra capacity — despite the absence of a Europe-wide equivalent of the U.S.'s Biomedical Advanced Research and Development Authority to enable large-scale investment in manufacturing capacity and R&D technologies.
"In manufacturing, there isn't an equivalent to BARDA but I am hopeful that other mechanisms like [the Coalition For Epidemic Preparedness Innovations], which is working with the G20, like the Gates COVID Accelerator, we can find ways to ensure that we have adequate capacity — not just for Europe and the U.S. This is a situation where we don't want [low and middle income] countries to lag [behind] the rest of the world in having access to technologies."