According to the company, lowering the price for Dificid in hospitals by 25% will only affect about one-third of sales, given that most patients treated for CDI are discharged from the hospital and finish the course of therapy on an outpatient basis. Optimer predicts that Difiicid prescribing will rise substantially in hospitals given the discount, as more hospitals may move to use the drug first-line because of the reduced direct cost to prescribe Dificid, as well as the ability to lower patient re-treatment rates, saving hospitals more money in the long run. Because nearly 70% of sales come from the retail pharmacy channel, the company believes that higher volumes driven by the new strategy will substantially offset the lower hospital-based price. However, the company will also need to address the high co-pays that a majority of patients need to pay when they pick up a prescription at the pharmacy. The company notes that a substantial number of private insurance company and Medicare/Medicaid patients still don’t have preferred access to Dificid. So in addition to the hospital discount, Optimer is implementing a Patient Assistance Program, which has so far demonstrated that the rate of prescriptions actually getting filled has risen from 29% to 75%, according to company data. Management, however, did not mention the cost of the Patient Assistance Program, and it is still unclear whether the increase in the rate of filling will be maintained on a broader scale and on a longer term basis. The actual co-pay that many patients will pay is not consistent, and may not be enough for certain groups to get them to follow through and fill their Dificid prescription at the pharmacy.
Disappointing 3Q sales results. Optimer announced today that gross Dificid sales to U.S. wholesalers in 3Q 2012 only increased by 2.2%, a disappointment relative to most analyst expectations. The company noted that treatments shipped from wholesalers to hospitals, retail pharmacies, and long-term care facilities in 3Q, rose by 5%, still below the growth that analysts were anticipating. Optimer notes that this is because of seasonality with the product (hospitialization rates are typically lower in the summer). With the disappointing 3Q sales results, the price reduction program, and the potential costs associated with the Patient Assistance Program, we believe analyst’s estimates are likely to be reduced, placing more pressure on OPTR.
OBI sale is a slight positive. On the plus side, the company announced that it is selling its 43% stake in Optimer Biotechnology, Inc. (OBI), a joint venture developing cancer treatments. Optimer will receive $60 million for its stake, representing non-dilutive capital to bolster the balance sheet.
Overall, we see Monday’s events as net-negative, as the company struggles to accelerate growth of Dificid, which is critical for increasing shareholder value. Expect OPTR shares to weaken further as analyst estimates may adjust downward after the Analyst Day. We do expect analysts to lower short-term sales estimates but raise long-term growth rates to continue to justify their price targets on the stock. The real question is: do investors believe the new strategy will be successful? As a result, OPTR remains a “show me” story.