Anbei meine Gedanken zu den Q1-Quartalszahlen (auf Englisch, da einfacher):

Positive

• „Floor“ 2030 guidance of $6.5b in revenue and $1.3b adj. EBITDA (= 20% adj. EBITDA margins) —> >100$ stock by 2030 if they execute
• Nearly 30% YoY revenue growth excl. GLP-1s
• Nearly 50% YoY subscriber growth in dermatology
• New verticals coming this year: low testosterone and menopause support, although later than earlier communicated („before year end“ vs. H1-25)
• Growing share of personalization (now 60% overall, 70% of new subscribers, 80% in dermatology, sexual health subscribers with daily solutions doubled YoY to >40%)
• Higher retention in sexual health and dermatology
• Higher personalization and retention are a clear sign of enhancing patient outcomes per dollar spent over time
• Strong operating leverage, especially in marketing
• Rising operating cashflow
• Growing cash position
• Updated guide to higher adj. EBITDA and adj. EBITDA margin
• Positive outlook on deepening partnership with Novo $NOVO B (+2,22 %) (more product lines / categories, potentially across geographies)
• New COO (Amazon veteran)
• Confidence in scaling platform globally
• Scaling operations (>700k square feet) and upgrade of equipment across facilities
• Roadmap to preventive care as mass market in the next 5 years

Negative

• Only 137k net subscribers added this quarter (last 4 quarters were all higher, only 6% vs. previous quarter)
• Revenue growth excl. GLP-1s showing signs of slowdown (nearly 30% YoY vs. 46% in the previous year) —> maybe due to shift in marketing focus on weight loss and volatility in sexual health
• 39% of Q1-25 revenue coming from GLP-1s ($230m in Q1-25 vs. $12m in Q2-24)
• „Disappointing“ outlook, i.e. no higher guide for Q2-25 and FY25, despite Novo $NOVO B (+2,22 %) deal
• Expected volatility in sexual health due to shift to personalized daily solutions vs. on-demand solutions
• Decrease in gross margins (73,5% vs. 76,8% QoQ), but expected to be temporary (sequential increase next quarter)
• Exploding CAC per net subscribers added (2x vs Q1-24) —> again, maybe due to shift in marketing focus on weight loss
• No buybacks, indicating fair value / overvaluation
• No CTO update
• Ongoing talks with Eli Lilly $LLY (+0,71 %) , but company seems reluctant, given negative stance on compounders

Bewertung

• Falls die 2030er Ziele erreicht werden: $6,5 Mrd. Umsatz x 20% Adj. EBITDA Marge x 20er Multiple = $26 Mrd. Marktkapitalisierung = ca. $100 Aktienkurs
• Fairer Wert heute: $42

$HIMS (-3,54 %)

$LLY (+0,71 %)
$HIMS (-3,54 %)
$NOVO B (+2,22 %)
$NVO (+3,03 %)

• Revenue: $12.73B (est. $12.72B) ✅; +45%
• Adj. EPS: $3.34 (est. $3.46) ❌; +29% YoY
• Net Income (Adj): $3.00B (est. $2.72B) ✅

FY25 Guide"

• Adj. EPS: $20.78–$22.28 (Prior: $22.50–$24.00)
• Revenue: $58B–$61B (est. $59.57B)
• Performance Margin: 41.5%–43.5% (Adj)
• Effective Tax Rate: ~17% (Prior: ~16%)
• Other Expense (Reported): ($850M)–($750M)
• Capex/Manufacturing: Expanded; 4 new facilities announced
• Guidance Based On Existing Tariff, Environment

Key Product Revenue (Q1 YoY)

• Mounjaro: $3.84B (+113%)
• Zepbound: $2.31B (Est. $2.3B)
• Verzenio: $1.16B (+10%)
• U.S. Revenue: $8.49B (+49%)
• Intl Revenue: $4.24B (+38%)

Other Key Metrics:

• Gross Margin: 83.5% (Adj); +100 bps
• R&D Expenses: $2.73B (+8%); 21.5% of revenue
• SG&A: $2.47B (+26%)
• Acquired IPR&D: $1.57B (or $1.72/share)

Pipeline Progress:

• Orforglipron (oral GLP-1) Phase 3 success

• Donanemab awaiting CHMP outcome

• Jaypirca approved in EU for R/R CLL

• Lepodisiran shows 94% Lp(a) reduction

• Baricitinib shows positive adolescent AA results

• EBGLYSS: 50% clear skin at 3 years

• Omvoh: sustained remission in Crohn’s

Business Developments:

• Expanded Zepbound vial offerings + savings for self-pay
• LillyDirect expands Alzheimer’s access
• >$50B U.S. manufacturing investment (since 2020)

CEO David Ricks Commentary

• “We had a solid start to the year with 45% revenue growth led by Mounjaro and Zepbound. Our pipeline continues to deliver, and we are scaling manufacturing to meet growing global demand.”

$NOVO B (+2,22 %)
$HIMS (-3,54 %)
$LLY (+0,71 %)

It is no secret that the release of GLP-1 drugs like Ozempic, Wegovy, Mounjaro have made these companies very strong buys in recent times.

However there is reason to hold caution in these companies, if simply buying because of these ground breaking drugs, and it is not tariffs, contrary to popular belief.

I would argue, it is in-fact America itself. You see, the reason these drug companies have been able to make so much money off of these drugs, is not because all americans are fat. Although there is some truth, in that the rates of diabetes and obesity in the states contribute to these revenues, it is actually the american health insurance system itself, which allows these drugs to sell at absorbent prices in the first place. You can't sell these drugs at the same prices elsewhere in the world, because governments, and entities like the EU do not allow it.

You see, the sale of GLP-1 drugs in america accounts for around 30-50% of revenue of the worldwide distribution of these drugs; And in the early days this was absolutely a golden goose. Because they are so powerful for weight loss. It made them extremely popular, and in turn, sales skyrocketed. However, this is exactly why there may be a problem.

You see American Insurance companies started losing so much money in coverage of these drugs, that many, if they continued at their current rate, would have not only lost money, but may have actually gone bankrupt if they continued for long periods of time. So the American insurance companies changed course, and started to reduce the coverage for these drugs:

• 
  Blue Cross Blue Shield of Massachusetts: Will stop covering GLP-1s for weight loss starting January 1, 2026, while continuing coverage for diabetes.
• Independence Blue Cross (IBX): Has restricted coverage for weight loss GLP-1s, requiring a diagnosis of Type 2 diabetes, cardiovascular disease, or sleep apnea for coverage.
• Blue Cross Blue Shield of Michigan: Has stopped covering GLP-1 drugs for weight loss for fully insured large group commercial members starting in January 2025.
• North Carolina's State Health Plan: Dropped coverage for weight loss GLP-1s for state employees in April 2024 due to high costs.
• Kaiser Permanente: Will drop base coverage for GLP-1s for weight loss for commercial and ACA members in California (with a BMI less than 40) starting January 1, 2025.
• MassHealth: Has transitioned coverage, with Zepbound becoming the preferred option and Wegovy and Saxenda being discontinued for most adult members starting in January 2025.

And most of all, American insurance companies, hold the most powerful card, in all of medicine. A sort of Trump card, so to speak. The use of Prior Authorization.

This is a foreign concept to most people outside of the US, and it is somewhat hard to understand. So to explain it as simply as possible:

It allows American insurance companies to deny covering anything they want. From medications to anesthesia or even surgeries. They do this in a convoluted way, but in simple terms, they hire their own physicians to review prescriptions from patients doctors, and accept or deny coverage, based on their Physicians opinions(the insurance companies), rather than a patients physician.

This in turn allows them to basically deny coverage for anything, for really any reason, as they don't really have to justify it in court, 99% of the time.

Even when coverage exists, insurers are implementing stricter prior authorization requirements, including:

• Higher BMI thresholds for coverage.
• Requiring trials and failures of non-GLP-1 weight-loss medications.
• Mandatory participation in additional weight-loss programs.
• Monitoring for a certain percentage of weight loss to maintain coverage.
• Medicaid: Coverage varies by state. Some states cover GLP-1s for weight loss, often with prior authorization and BMI requirements.
• Medicare: Generally does not cover weight loss drugs, although there are exceptions if the drug is also approved for another medical condition (like cardiovascular risk reduction for Wegovy in certain patients).

So in conclusion, these companies can still do very well with these drugs, and still make a lot of money, but the tides are shifting, and the well of wealth is not endless, so it may be wise to temper some expectations.

$NOVO B (+2,22 %)
$LLY (+0,71 %)

LONDON, April 25 (Reuters Breakingviews) - The pecking order of the obesity drug market is shifting. Eli Lilly (LLY.N), the $815 billion maker of blockbuster weight-loss drugs Mounjaro and Zepbound, is trading at more than double the valuation multiple of Wegovy maker Novo Nordisk (NOVOb.CO), whereas once the two were equally richly valued. It will be hard for the Danish group to close the gap.

The companies run by David Ricks and Lars Fruergaard Jorgensen are long-standing rivals in diabetes. They have lately benefitted from the boom in GLP-1 drugs, which numb users’ food cravings and enable rapid weight loss. As recently as April 2023, both were roughly equally valued at over 30 times forward earnings, as per LSEG data.

Novo Nordisk’s fortunes turned last December when its hotly anticipated treatment CagriSema failed to meet expectations on weight loss and tolerability. The drugmaker’s share price has since collapsed, and it is worth just $269 billion, a third of Lilly’s market value.

Eli Lilly has also faced challenges. Its sales have been slower than expected due to shortages and its forward earnings multiple has fallen from the peak of 57 to 35 times, as per LSEG data. But the U.S. group is trading at a significant premium to Novo Nordisk: the latter now has just a humdrum 14 times multiple, in line with ordinary pharma group AstraZeneca (AZN.L).

This gap between the two is down to Eli Lilly’s superior treatments. In head-to-head trials, users lost more weight using the U.S. drugmaker’s obesity medication. This year, Eli Lilly’s diabetes division, which includes obesity sales, is expected to grow by 41%, as per Visible Alpha forecasts, versus 25% for Novo Nordisk’s comparable business.

Eli Lilly has also had some big wins. Earlier this month, the U.S. drug giant revealed details of a trial of its obesity pill orforglipron which added $100 billion to its market value. This year it will release trial data for new medication retatrutide, known as “triple G” because it targets three hormones instead of just one. Users lost 24% of their weight in an earlier trial, potentially making it the most promising weight-loss drug to date.

Novo Nordisk is fighting back. It’s looking to get regulatory approval to sell a weight-loss pill in the U.S. this year and is also hoping GLP-1 drugs can help treat Alzheimer’s. Yet the obesity market will also see new entrants like Roche (ROG.S), join the fray soon. And Novo Nordisk may be more vulnerable given its drugs’ lower efficacy, which may dent its valuation further. As competition bites, Jorgensen will come under pressure to find new revenue streams beyond obesity and diabetes, which accounted for over 90% of last year’s $44 billion of sales. The risk of expensive M&A may be one more thing for investors to worry about.

Eli Lilly said on April 17 that an under-development oral treatment caused weight loss of nearly 8% in patients on the highest dose, and lowered blood sugar in patients with type 2 diabetes in a late-stage clinical trial. Participants were still losing weight when the trial ended. Lilly is conducting six more late-stage trials of the drug.

Lilly said the drug, orforglipron, had a safety profile consistent with similar approved glucagon-like peptide-1 (GLP-1) receptor agonist therapies. Large-selling rival treatments, however, are injectables, while orforglipron is a pill.

https://www.reuters.com/breakingviews/obesity-drug-boom-has-new-pecking-order-2025-04-25/