A few pharmacies !

Pharma sector is a mammoth among the healthcare spectrum with the presence of a number of players from generic to non generic, formulations to APIs, CDMO to CRO, biologics and biosimilars. Each sector has a few players competing among themselves to get a chunk in growing markets. I have tried to cover the basics about healthcare sector in  https://www.sinewavesecurities.com/2022/06/healthcare-mamoth-among-moles.html Do give it a read for the basics. 

Here I have taken examples of few companies, study their financials and business model and try to enhance “circle of competence”.

DRL -25/25/25 !

Dr. Reddy's Laboratories Ltd is a leading India-based pharamceutical company which offers a portfolio of products and services, including Active Pharmaceutical Ingredients (APIs), Custom Pharmaceutical services (CPS), generics, biosimilars and differentiated formulations.

Global Generics Segment (~80% of revenues):

This is the main business of the company wherein it offers 400+ high-quality generic drugs, keeping costs reasonable by leveraging its integrated operations. The company benefits from its expertise in active ingredients, product development skills, a keen understanding of regulations and intellectual property rights & streamlined supply chain.
Top revenue contributors of the segment are nervous system drugs (19%), gastrointestinal (14%) & oncology (13%).

Pharmaceutical Services & Active Ingredients (PSAI) (~15% of revenues):

The company is one of the largest manufacturers of APIs in the world. It works with several leading generic formulator companies in bringing their molecules first to the market. Its API development also helps its own generics business to be cost competitive and get to the market faster than competitors.

The company's R&D expenses as a % of total revenues has come down from 13% in FY18 to 9% in FY21.

USA accounts for 44% of revenues, followed by India (18%), Russia (10%) and others (28%).


Number crunching

Mcap – 72000 Cr

Book Value  per share - Rs. 1114

Sales- 20800 Cr

Gross margin 50-55% (gross margin for the Global Generics and PSAI were at 57.7% and 21.6% respectively )

OPM – 20%

Management- Mr. Erez Israeli --  CEO; Mr. Parag Agarwal --  CFO

Erez-  We continue to make good progress on our strategy execution by enhancing our development pipeline of both small molecules and biosimilars, continuing with our new products launch momentum, gaining market share in key products, making inroad into newer sets of markets in Europe, driving productivity and accelerating our innovation agenda.

Target – 25 EBITDA RoCE

What When How.

Consolidated revenue for the quarter(Q1FY22) stood at Rs.4,919 crores, that is US $662 million and grew by 11% on year-on-year basis and by 4% on a sequential quarter basis. The growth is mainly driven by new product launches including COVID products, higher base business volumes, full quarter impact of portfolio acquired from Wockhardt in Q1 FY'2021 and was partly offset with price erosion in some of our products mainly in US and Europe.

While the gross margin in current quarter(Q2FY22) was impacted due to price erosion, product mix and increase in input material cost, primarily on KSM, solvent and other fuel, it was supported by out-licensing income and leverage benefit for manufacturing overhead. Gross margins from the global generics and PSAI businesses were at 56.9% and 25.9% respectively for the quarter.


The growth was primarily led by :
(a) higher volumes due to seasonal demand, 
(b) revival in market growth after a negative impact due to COVID in quarter 1, and 
(c) launch of biosimilar Bevacizumab

Product mix used as leverage to balance gross margins.

Export incentive that was withdrawn has clearly put a downward pressure on the gross margin. There is some pressure that is there because of the North American price erosion. "To offset its impact we drive higher sales growth and we sweat our asset, we can leverage the cost base and the second is the product mix. Some of our significant high value launches are margin accretive. So overall, I don’t believe that there is a downward trend in gross margin, gross margin fluctuates from one point to another and we are fairly confident of the margin profile of the generic business.”

New Platform coming up- Successfully managed to expand our business model ‘Beyond the Pill’ through digital innovation and true demonstration of that is the launch of SVAAS, an app-based integrated OPD service delivery platform in India. This will provide simple and high quality healthcare by addressing patient needs for doctors, pharmacies, laboratories and insurance all under one roof.

“First, it's not an app, it is a OPD service that we are giving to people and people in this case it's a collaboration, we will get under an insured service, their needs under one roof, meaning we are going to provide them the healthcare that they deserve in much better service and much cheaper than they used to, to get to buy the current alternatives that they have. The beauty of that is an end-to-end platform, in which comprise the physicians, the insurer, the pharmacies, the delivery, the information and everything under one roof.”

D2C

“We are basically on the last stages of finishing the pilot. We are now present in 5 cities, going to 10 cities in the next few weeks. This will cover of course the main cities of India including Mumbai and Delhi. Accordingly will be the roll out of the companies that will join this platform. Our main way to grow this business is by convincing the companies to work with us and give treatment to direct consumers and basically insured by our insurance in this product. And of course, rolling out good services by physicians as well as by other vendors to provide excellent service. This is very niche project and I'm very proud of the beginning and believe in it very much. It's a good thing for us and I believe it's a very good thing for India as a whole.” (ROBUSTNESS EXAMPLE)

Covid Impact and Stocking issue

PSAI business recorded sales of $102 million with a year-over-year decline of 10% and sequential quarter decline of 6%. This was largely due to higher sales base for business during same quarter in last year owing to stocking activity by our customers as a response to mitigate the COVID-related potential disruptions. Considering the nature of this business, we expect some fluctuations in quarter-on-quarter sales due to lumpiness in order book

India vs US market

 In India and emerging markets, yes, but it's also supported well with the sales and the profit. So, this is a very healthy business, it is growing and it's paying for its investment plus with great return on investment and great EBITDA.

The activities that are related to more geographic spread as well as services as they are taking current products and expanding into other areas. RoCE as well as the EBITDA in India is above our average. There is a good chance that India, as a market, will be bigger than United States in three to four years to come.

Horizon 2, the future of the company, the activities that will generate growth for the company, post-2026, post-2027, will derive from innovation that will be initiated in India, with partners in India and outside of it.

"Seeing good growth in our market and therefore we are putting money behind our brand in the branded markets like India and Russia. We are also investing behind digitalization both frontend and backend, so that is one part of it."

Price erosion is part of the business model of work in United States in the generic sector. It's part of the game. There are relatively fewer customers. There are many people that are supplying them, and the customers can choose between people. As long as there is a margin in system, they will negotiate those. That's the business model. Price erosion is a function of how many products have been in these situations. It's not a macro trend, it's a part of the business model. 

"We are building a portfolio of 25 to 30 products a year, and continue to do that. Some of them are like Icosapent next year, like Revlimid next year, and other products, are promising, in terms of the value. This is the business we are and that's the nature of the market."

The specific capital allocation for the United States moved from about 90-percent-plus in FY16 to about 15 percent in FY22. Overall, the injectable and the complex generic will drive the growth in the United States on the generic path and it will grow faster than the retail product.

USFDA – Perennial tailwind
US FDA audited for formulation manufacturing facilities FTO7 and FTO9 was completed - issued a form 483 with 8 observations.

Next few quarters- The main growth will come in the next, so overall strategically, the main growth will come when the new portfolio of API, which will of course support launches by our customers including our own internal use of the newer API. So if you wish our API business with the biggest products that is primarily driven by a group of products or let us say veteran in the generic business and the new products that will be launched, primarily peptides, will replace pareto products in the next coming years. Specifically, the API is doing well given the fact that on one hand you have increase in commodity and you have intensified competition of some of these key product, but we are doing well in penetrating with the newer product and I believe that, within the next few quarters, we will see sustainable growth. The fluctuation that we see now probably will continue in the next 2 to 3 quarters.

“Our strategy for the last 4 years, we are investing in other markets for growth in both India and emerging markets and this is providing us by using the same fixed assets based on our portfolio, our assets, our knowledge, etc. this is allowing us more growth with less risk. The United States will continue to be an important market for us. I just want to emphasize on it and we will continue to invest and grow in the United States. The other emerging markets anyhow will grow faster than the United States. Therefore, then the average weight of the United States will decrease, is decreasing already and will decrease over time. And the capital allocation is done accordingly to the diversification efforts."

R&D Spend

“We are spending on our generic portfolio for the spaces in each one of the markets, mainly in United States, China, Europe, emerging markets, we are trying to globalize products, so we are developing products for more than one market, and if possible to all of the relevant market, which was the part of the productivity products, but this is in line of our core business."

They are spending money on the biosimilars and recently, also on the COVID products as well as vaccines, specifically for India, Russia, certain clinically differentiated products, developing APIs as well as intermediates as part of that. There is a small group under a branch of Dr. Reddy’s, Aurigene discovery that is developing products for immuno-oncology with the business model in which they are taking some of the assets and licensing out in early stage for financing the products that are to be developed. The current business model of generic, branded generic and API will continue to be the main business.

"We want to create the growth of our core business as well as building the new franchises and maintain 25-25. This is the challenge that we took upon ourselves and so far we are in that direction."

Biosimilars-Robustness ratio guide

“Biosimilars, I believe that calendar year of 2024, we will start to see more meaningful contributions and as we are now investing, the sale that we have especially in emerging markets, by building more capacity and indeed this is our business model and of course licensing in for the United States. So this is right now the model and this continues to be the model probably until the calendar 2024 or fiscal 2025. As for the margins, I am reiterating the famous 25-25, as we are sharing well, we are very much in that direction and it is coming faster than we anticipated, let us say, 3 years ago, so we are very close to that.”

“We have rituximab which we have now commercially with most of the emerging markets, and the primary markets for it today are India and Russia. And then we have the bevacizumab and additional 4 biosimilars primarily for emerging markets”

“Overall, it's a healthy portfolio that cover us very nicely from about 2024 until 2031-2032 in which we will launch all of these products.”

Less risky CDMO bet ?

“PSAI is comprised also of our CDMO activities that are slightly picking up. And we very much believe in it. So, most of the seeding that is done now are with small projects which are in Phase-1 and early Phase-2 and naturally some of these products will come to Phase-3 and beyond that and of course serve as a growth driver for the CDMO type of the business which is as I discussed in the past part of our Horizon-2 activities and it's seeding and picking up.”

 Overall DRL is one of the prominent players with lot of institutional investors, top notch management and plans to transform from generic US to specialty diversified company.  

Let us have a look at Aurobindo Pharma now !

Aurobindo Pharma      

Numbers

Mcap-41000Cr

Sales= 23,650 Cr TTM & FCF=1500Cr and PAT/CFO= 85% 

Focus on organic and inorganic growth-600+ANDAs

250+ DMFs +70% API integrated business

60% Gross margin business

R&D-1510/23681~6.3%

Insights - Concall Snippets and Future guidance

Formulations business clocked a revenue of Rs.5,211 crores, increased by 2% year-on-year. In the Formulations business, US business posted a growth of 8% year-on-year to Rs.11,231 crores in FY'21

API business clocked a revenue of Rs.3,086 crores for the year; for the quarter, API business increased by 5% to Rs.794 crores.

 On a constant currency basis, US business increased by 4% year-on-year to around US$1.5 billion. For the quarter, on a constant currency basis, US revenue ex-Natrol was at US$393 million, increased by 5% year-on-year.

In APIs, almost 60% is antibiotics and 40% is nonantibiotics.  On nonantibiotics, selectively  seeing some price improvement.

Revenue of AuroMedics, our Generic Injectable business declined by 10% year-on-year to US$249 million for the year due to reduction in hospital procedures on the back of COVID-19. For the quarter, AuroMedics sales increased by 13% year-on-year to US$67 million. We have filed a total of 145 injectable ANDAs as on 31st March 2021, out of which 91 have received the final approval and the balance 54 are under review.

Take a LOOK---20% revenue from injects (14 gen +6branded) ie 23681*20%=4736.2Cr   out of which US=1875Cr RoW=2861Cr

In FY'2021, ARV Formulations business grew by 49% year-on-year to Rs.1,863 crores. In Q4 FY ‘21, ARV revenues grew by 29% year-on-year to Rs.491 crores. Our Global Generic Injectable consolidated revenue is $395 million for the year. Apart from this, Acrotech, our branded injectable business achieved a revenue of US$103 million for the year.

Most of the growth has come from Dolutegravir and its combinations—NOT COVID molecules

Way Forward=Maintain this for 2 yrs and flatten then

State of US business—50% revenue- As far as the US business is concerned, there is a bit of erosion. We always budget for a mid-single-digit erosion and we have seen mid-single digit at this juncture. As we progress, we will recalibrate on how the market is performing. But as you are aware of it that since we have several avenues in terms of the US market, so we don’t see that as an issue, there could be a minor blip in the short-term and we don’t expect that to continue for a longer term, that is as far as U.S. is concerned.

Areas of focus from ORALS to peptide to depot injections to vaccines to biosimilars

FUTURE IN US- There has been enough investment which has gone in and in the next two to three years most of it would have reached critical stage for commercialization. Definitely we are convinced about whatever investment which has been made and we are confident about the return from those investments which has happened so far. Having said that, till we reach that particular fructification of those opportunities, we have enough opportunity in terms of the filings which has happened in our orals and injectables. You have already heard that in the next three years, we would like our injectable business to reach around $700 million.+API ---5460Cr rev @20%-25%OPM

In Biosimilars, we will be filing two products this year and two products next year.(oncology biosimilars)

Antibiotics, cold medicines and those things where we are having. We have not seen much movement, but definitely we are expecting in the coming quarter onwards it will slowly improve. To come par with the before years, it may take another four quarters. Majority of the consumption would happen in winter, but the procurement will happen in summer. So in next two - three months we will have clarity on where we stand

Overall 10 hormonal and 65 oncology products are under development with addressable market size of more than $45 billion. As on 31st March ‘21, we have filed 41 ANDAs including 31 oncology that is including the 13 orals and 18 injectable and 10 hormonal products. So, we have enough headroom for us to continue working on that. At this juncture, we have got approval for 15 products and we have launched 13 products.

In complex injectables there are at least 15-20 products including depot injection. We are going to take exhibit batches for four depot products in next three - four months and where filing may happen by end of this financial year. Majority of the critical injectables will be manufactured from US plant because of some specialty manufacturing lines required. These include pen injections. So lots of things are happening on the difficult to develop injectables side.

Second highest number of Certificate of Suitability (CEPs) globally and second highest number of DMF filings in the US by an Indian Company. 

Filed 251 DMFs with the USFDA and over 3,000+ filings in other geographies. Total revenue including captive consumption amounts to US$ 206 Million for Q3FY21 and US$ 632 Million for 9MFY21. Aim to double the external sales in next 4-5 years

Biologics, Peptides and others—As cash rich-Inorganic growth opportunity.

"We have not launched Ertapenem in Europe yet and the penem block is being expanded so, we will be launching Ertapenem and looking forward to that very soon. You heard about the Vizag general injectable plant, which will be in operation in 18 months and we are developing close to 50 products, which are going to be very helpful for our hospital taskforces in Europe. We have a very good market share in hospital with products which are sourced from Europe and plus we have two biosimilar products which will be filed next quarter. So, you can have a complete picture about our plans for higher margin products and opportunities."

As we get to know the details of various business verticals of Auro and targets layed down by management going forward calling it dead would do injustice to the mammoth. It is discounted or fairly valued ? Well it is the question one needs to ask herself before investing. 

Now lets see Gland Pharma - a much talked about stock, numbers, management's vision and product mix.

Gland Pharma deals in 3 major verticals-Injectables, Oncology and Ophthalmology. Its main business comes from US-61% ,16% India and 23% ROW.

FOSUN Pharma—Chinese promoter     

Asset Turns-2.8x

Gross Mg-55-60%

 P/S-16x & Mcap 57000Cr         

B2B-US and RoW & B2C in India

B2B Advantages

Gland's B2B Model  Include Stable Cash Flows, Better Profitability Profile, Margin Stability from Natural Hedge Against Raw Material Pricing and End-formulation Pricing Fluctuations

Steady / Predictable Cash Flow Long-term supply contracts with marketing partners ranging from 3-5 years and stronger partnerships due to lack of injectables manufacturers with good regulatory track record.

Products licensed to marketing partners strong in particular therapeutic areas resulting in higher market share 6 Lower R&D Litigation Risks

Better Operating Profits Efficient cost profile due to relatively lower SG&A vs B2C players Reduce risk by partnering with a marketing partner to cover RSD litigation expenses

Revenue Growth: 2014-19 Gross Margins: 2019 40.1% 34% 5 Lower RM/Formulation Pricing Risk Gland B2C Players Gland B2C Players.

Due to differentiated B2B Model, Gland can derive scale benefit at a product as well as formulation level and lower Working Capital Requirement Revenues through transfer pricing are immune to raw material price fluctuations. Transfer pricing also helps regulate any adverse impact from price erosion in end-formulations, as it gets restricted to the profit share component

Lower requirements due to better inventory management, planned payables and better visibility on receivables Gland has Demonstrated Faster Revenue Growth in Last 5 Years While Generating Superior Margins vs B2C and B2B Players

About injectibles

About  Injectables---CAGR 10.1% growth

Injectables: One of the Largest and Fastest Growing Segment Growth Opportunity - Injectable formulations is the fastest growing segment in global pharmaceuticals, recording a 2014-2019 CAGR of 10.1% vs overall pharma market at 5.8% 

Global generic injectables market is estimated at US$131bn growing at a 2014-19 CAGR of  8% - US the largest market i.e. c. 33-34% of market) is expected to grow at a 16% CAGR from 2019-2024E. 

US$61.3bn in injectable brand sales expected to lose patent protection between 2020-24 (vs US$33bn in sales which post patent protection lost between 2014-19. Rising prevalence of chronic diseases Convenience and benefits of New Drug Delivery System Growth Drivers for Injectables 

New market opportunities - Drug shortages in the US - from 2014 to 2019. 40-60% of the shortages have been in injectables space.

Market Entry Barriers - High capital investments Manufacturing complexities to meet stringent quality standards, high level of compliance and regulatory requirements and consolidation trend expected to favour established players Activate Windows

Penem Antibiotics Injections like Ertapenem , Meropenem, Cisatracurium, Enoxaparin, Heparin, would you say that your Q4 numbers be the largely normalized numbers

Concall Snippets:

After Vaccine 250mn doses- started with contract manufacturing contract development and to getting to own development. "I think that is the path that we want to take, we want to dive in quickly into our own development, so this opportunity what we took now is kind of a learning process for us and last year we have been talking to people and they are expressing interest to move biosimilar manufacturing. Which business model in biosimilars-If you look at our business model that will continue, we always partner with people, we do not take products or we do not get into development unless we have some partnerships and that model will continue."

It has single use bioreactors but to a certain extent to get to the scale of vaccine we have invested to an expansion for the commercial production as well as procure the bioreactors.

Why high margins? Some products not many players are there that is one of the reason even if you look at the top ten products in the company, five products or six products they make their own API so that gives an advantage in terms of backward integration and the capacities what we have in terms of facility utilization, capacity utilization that also is helping keeping those margins. So, it is a mix of backward integration, mix of the output we are giving through manufacturing sides and also the product mix in the markets it is the combination of these which is helping to keep those margins intact.

Peptide APIs-"Peptide side, yes, we like I just mentioned before this call we are working on some of the complex products including some peptides and some hormonal products and some suspensions. So, one of the peptides complex peptides is that we do expect to be filed this year and next year will be a couple more."

Biologics - Way forward- "We are going up to 1 KL. I would say and then we will get into the other areas and then understand the demand and the technology. It all depends on the drugs substance technology as well. Like I said our idea is to enter into CMO kind of a business, CMO/CDMO and that will dictate what kind reactors we need getting into that basis."

 62SKUs for 2022FY

Anti Thesis-

Why Gland Pharma seems relatively expensive Low gross margins (50-55%) vs 75% for pure play CDMO Very low CFO/EBITDA conversion of just 50% 17x sales seems exorbitant for very low CFO/EBITDA and relatively low gross margins

Top 10 molecules contribute about 57% at the company level

GLAND vs AURO- High USFDA risk at 17x sales vs very low USFDA risk (> 95% non US sales) at 4x sales. Latter also has better gross margins, better CFO/EBITDA conversion. Long term compounding works when known risks are low. The upside is wide open in such cases.

Gland Pharma continues to be niche business and hence trades at niche valuations. Can it justify its price to perfection valuations of time or price corrections awaits ?


Disclaimer - This is not any investment advice. Please consult your financial advisor before investing.

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