One thing that I noted but wasn't able to find a trade expression for, was that you'd probably see a decrease in mobility scooters, especially bariatric ones, for obese people.
Originally I wrote short IVC, but then it turned out IVC stopped listing a while back.
If anyone knows of publicly listed companies that are focused majorly on mobility scooters, please share.
Before going to the beach for their TikTok I guess people will have to do something for their loose skins. After losing weight this much that is bound to happen. Any ticker for plastic surgery, skincare? That should also fit in your thesis on luxury goods/services(?)
Great thesis and writeup. Planet Fitness (PLNT) is an excellent short as in addition to what you mentioned Edwin Dorsey of TheBearCave substack highlighted a number of issues with it
@Citrini Have you seen any data regarding carbonated soft drink consumption distribution (similar to that WSJ chart on beer) and/or early sample data of consumption change once for people on Wegovy? Cheers.
Why no ELV in the health insurance basket? In any case, I’ve been debating how quickly they’ll see the benefit and I think it will be quite soon. Obese folks will not wait for coverage- anyone who can afford it will go straight to the online prescribers and sketchy clinics to get it started asap. And there’s a lot of people with money and fat
Amazing write up and I like the citations to support your work. This is like a scientific manuscript. I have a question for you regarding generics in this space. I read an article from JAMA noting that GLP-1s are having a much longer patent duration before they go generic when compared to other drug classes.
"The median total duration of expected protection after FDA approval, when accounting for both preapproval and postapproval patents and regulatory exclusivities, was 18.3 years (IQR, 16.0-19.4). No generic firm has successfully challenged patents on GLP-1 receptor agonists to gain FDA approval."
Does this make you more bullish for NOVO and LLY? Could this hurt the general class due to higher cost for longer if generics don't come online? Thanks in advance.
So I think that NVO and LLY will be able to maintain an effective duopoly over this market for at least the next 3 years. However, the inflation reduction act includes mandatory discounting for these drugs by 2031 (as well as insulin) and overall I think, as I mention in the article, that it will be too profitable to not attract significant competition. Overall, I think that’s why this is a trend that the net effects have not truly been felt yet - once the competition heats up and NVO/LLY lose their duopoly we will start to see more of the second order effects of the drugs getting more affordable.
Philips – growth and margin inflection – From an all-time high in April-21, Philips’ shares have underperformed EU Medtech over the last two years as a consequence of a volatile operating environment compounded by company-specific challenges. While some elements of uncertainty remain, we think the company is emerging from this challenging period and the shares represent good value. We see upside risks to consensus estimates and scope for multiple expansion. Easing supply chain constraints, pricing and the impact of Philips’ productivity programme support our expectation for a 2Q adj. EBITA beat on July 24. While we await better visibility on Sleep & Respiratory Care, we think conservative consensus expectations create an asymmetric risk profile. We initiate with a Buy rating and 12m price target of €28.
This is awesome work.. your Substack is truly a gem.
What are your thoughts on CVS as a beneficiary as well? Their current leverage is a bit concerning (although I think it's blown out of proportion), but their long-term vertical integration play could make this an interesting opportunity for them in many ways.
There are a few considerations here. Mainly that the negative effect would come from decreased volumes. So we have to look at gross margin, which companies make up most of their profit on volume of food sold. Then take a look at the consumer demographics and cross reference geographic density with areas that obesity is higher (to determine the likelihood customers would be patients on these drugs). I have done a rough approximation with the companies I selected but if there’s enough demand I can go into the alt data and provide a more comprehensive analysis. I think it will begin to matter more once mounjaro is approved for weight loss.
Hope everyone enjoyed the article.
One thing that I noted but wasn't able to find a trade expression for, was that you'd probably see a decrease in mobility scooters, especially bariatric ones, for obese people.
Originally I wrote short IVC, but then it turned out IVC stopped listing a while back.
If anyone knows of publicly listed companies that are focused majorly on mobility scooters, please share.
Would be great to see this change in the society!
Before going to the beach for their TikTok I guess people will have to do something for their loose skins. After losing weight this much that is bound to happen. Any ticker for plastic surgery, skincare? That should also fit in your thesis on luxury goods/services(?)
It’s difficult to find a pure play on abdominoplasty but if you have any ideas I’m all ears.
InMode could be one of them.
This is great yeah, I added it!
Great thesis and writeup. Planet Fitness (PLNT) is an excellent short as in addition to what you mentioned Edwin Dorsey of TheBearCave substack highlighted a number of issues with it
Hey, I did mention it! If you take a look at the short basket it’s in there 😉
Yes, I saw that!
Nicely done. Todays pop is crazy. Def Pfizer viagra vibes
https://www.kff.org/health-costs/poll-finding/kff-health-tracking-poll-july-2023-the-publics-views-of-new-prescription-weight-loss-drugs-and-prescription-drug-costs/
Restalyn and juvederm face fillers should have a lot of potential,no? ABBV , Galderma
@Citrini Have you seen any data regarding carbonated soft drink consumption distribution (similar to that WSJ chart on beer) and/or early sample data of consumption change once for people on Wegovy? Cheers.
Why no ELV in the health insurance basket? In any case, I’ve been debating how quickly they’ll see the benefit and I think it will be quite soon. Obese folks will not wait for coverage- anyone who can afford it will go straight to the online prescribers and sketchy clinics to get it started asap. And there’s a lot of people with money and fat
So you think sequence - weight watchers has an advantage over say HIMS once it gets into weight loss drugs (stated by end of 2023) ?
Fantastic work. How about hospital network stocks such as HCA? Large swath of admissions will be avoided. Some of these stocks are at all time highs.
Am I mistaken or did you edit this post and take out the peptide research longs that were under the GLP-1 basket? Was that intentional? Thanks!
They’re there!
If you CTRL+F ILMN you should find them
Amazing write up and I like the citations to support your work. This is like a scientific manuscript. I have a question for you regarding generics in this space. I read an article from JAMA noting that GLP-1s are having a much longer patent duration before they go generic when compared to other drug classes.
"The median total duration of expected protection after FDA approval, when accounting for both preapproval and postapproval patents and regulatory exclusivities, was 18.3 years (IQR, 16.0-19.4). No generic firm has successfully challenged patents on GLP-1 receptor agonists to gain FDA approval."
Does this make you more bullish for NOVO and LLY? Could this hurt the general class due to higher cost for longer if generics don't come online? Thanks in advance.
So I think that NVO and LLY will be able to maintain an effective duopoly over this market for at least the next 3 years. However, the inflation reduction act includes mandatory discounting for these drugs by 2031 (as well as insulin) and overall I think, as I mention in the article, that it will be too profitable to not attract significant competition. Overall, I think that’s why this is a trend that the net effects have not truly been felt yet - once the competition heats up and NVO/LLY lose their duopoly we will start to see more of the second order effects of the drugs getting more affordable.
Philips – growth and margin inflection – From an all-time high in April-21, Philips’ shares have underperformed EU Medtech over the last two years as a consequence of a volatile operating environment compounded by company-specific challenges. While some elements of uncertainty remain, we think the company is emerging from this challenging period and the shares represent good value. We see upside risks to consensus estimates and scope for multiple expansion. Easing supply chain constraints, pricing and the impact of Philips’ productivity programme support our expectation for a 2Q adj. EBITA beat on July 24. While we await better visibility on Sleep & Respiratory Care, we think conservative consensus expectations create an asymmetric risk profile. We initiate with a Buy rating and 12m price target of €28.
This is awesome work.. your Substack is truly a gem.
What are your thoughts on CVS as a beneficiary as well? Their current leverage is a bit concerning (although I think it's blown out of proportion), but their long-term vertical integration play could make this an interesting opportunity for them in many ways.
Hi Nikunj,
There are a few considerations here. Mainly that the negative effect would come from decreased volumes. So we have to look at gross margin, which companies make up most of their profit on volume of food sold. Then take a look at the consumer demographics and cross reference geographic density with areas that obesity is higher (to determine the likelihood customers would be patients on these drugs). I have done a rough approximation with the companies I selected but if there’s enough demand I can go into the alt data and provide a more comprehensive analysis. I think it will begin to matter more once mounjaro is approved for weight loss.
Hope that helps!