Hi, very good and relevant questions for the investment case! I think there could already be some minor impact in 2027, but in terms of scale it would still be small enough to be overshadowed by the overall Nubeqa picture. So, I took a bit of a shortcut with my wording. Reasons why I consider the '27 impact to be small:
- In many cases, it is likely easy for doctors to justify Nubeqa based on its milder side effects.
- As I understand it, the medication cannot be switched for current patients because cancer drugs are “protected” under Medicare. In other words, the impact would mainly concern new patients.
- The market entry of generic enzalutamide will, as far as I understand, only affect insurer policies starting in 2028. Price negotiations for Nubeqa will, based on my understanding, take place in spring 2027.
In our forecast, Nubeqa continues largely with its current strong momentum next year. A small extra boost will still come from reaching the top royalty tier slightly earlier again. In 2028, growth then slows down for the aforementioned reasons, and in 2029 it stalls as a result of the IRA. From 2030 onwards, there will be growth again from indication expansions, until Nubeqa’s revenue turns into a decline starting in 2033 due to patent expirations.
In those figures for Orion, there are also future milestones modeled with a 50% probability, for example for opevesostat, which is why the above isn’t reflected quite so straightforwardly in the group-level forecasts.
The best estimate for Nubeqa’s 2027 will certainly come from Bayer’s guidance, which will presumably be provided in connection with the Q4 report in February.