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A common motif among the biopharma CEOs who spoke here on day one of the J.P. Morgan Healthcare Conference involved turning the page.

Perhaps the starkest example came from Pfizer CEO Albert Bourla. 

“Clearly, 2023 was not a good year for us,” he acknowledged during a fireside chat Monday afternoon. “We missed our internal projections and also we missed the expectations of the street.” 

Unsurprisingly to most, Bourla said the miss stemmed predominantly from the big drugmaker’s COVID-19 franchise, consisting of vaccine Comirnaty and antiviral Paxlovid. Shortfalls there contributed to lower revenues overall and led the company to cut revenue guidance not once but twice.

“Also, we didn’t impress very much with the commercial performance of the other products,” continued Bourla. “We were a little bit behind. And clearly that was shown in our stock performance, which was very, very bad. That hurt a lot.”

The pharma company’s fall from grace was all the more painful considering, “We used to be the stars of the industry for a few years,” Bourla lamented. 

He was referring to the pandemic era, when Pfizer was lauded for creating the vaccine, expediting its development and securing regulatory approval within the span of a year, then collecting record revenues.

Cutting losses involved renegotiating some of Pfizer’s multi-billion-dollar, COVID-related government contracts, after Bourla said those governments decided not to honor the agreements. 2023 also saw continued transition from government-supplied to commercially distributed COVID products in other countries, which led to changes in pricing and market access.

Moving forward, though, while expectations have been reset and 2024 will be a “clean slate,” the street is looking for a clear path to growth. Analysts see few assets in the portfolio to reclaim its former glory.

Pivoting to the future

Meanwhile, fellow coronavirus shotmaker Moderna was intent on moving past the pandemic, too.  

“Often we’re perceived as a COVID company,” CFO Jamey Mock told the JPM crowd. “Hopefully, your takeaway from this presentation is that we’re much more than that.”

Mock spent much of his time arguing that Moderna is an mRNA platform company with capacity far beyond COVID. The firm, he said, expects to incur losses over the next two years. 

However, it’s made good progress in diversifying the late-stage pipeline into four areas: respiratory vaccines, (including a COVID booster), along with vaccines against RSV, flu and a COVID/flu combo. 

Additionally, Moderna is working on a next-gen refrigerator stable COVID jab; individualized neoantigen therapy (INT) mRNA-4157, which it’s co-developing with Merck in combination with Keytruda; a vaccine against cytomegalovirus (CMV), the leading cause of birth defects; and rare disease.

That said, COVID revenue will remain a prime driver in the near term, with Spikevax’s 2023 product sales coming in around $6.7 billion and the vaccine’s 2024 sales expected to be about $4 billion. Moderna saw an 11% COVID market share gain in the U.S. to 48% in 2023 against what Mock called a “tough competitor” – i.e., Pfizer/BioNtech.

Molding a new Merck

Possibly the most notable update of the day came from Merck CEO Rob Davis, who also spoke of shedding an older image. 

“We’ve been a story of Keytruda, Gardasil and execution,” he said. Now, that story is increasingly marked by new product launches and what Davis called “one of the broadest, deepest pipelines we’ve had in years.”

Still, it’s one that may be underappreciated by the street. Management voiced strong enthusiasm for the upcoming launches of sotatercept in PAH as well as V116, a vaccine for pneumococcal disease. With their Food and Drug Administration decision dates coming up in March and June, respectively, management made clear that each is a multi-billion-dollar opportunity.

The company also upgraded long-term guidance for its oncology franchise to over $20 billion versus more than $10 billion prior, thanks to the addition of novel antibody drug conjugates (ADCs) from its October collaboration with Daiichi-Sankyo as well as durability of data seen in individualized neoantigen therapy (INT) V940, which it’s co-developing with Moderna. 

This morning’s $680 million buyout of Harpoon Therapeutics, a biotech specialized in developing tri-specific T cell engagers (TCE), further bolstered the oncology unit. 

For the cardiometabolic franchise, Merck upped long-term guidance to $15 billion versus over $10 billion prior, on the back of stronger-than-expected potential from sotatercept. The increased confidence also stems from MK-0616, which is an oral PCSK9, and from MK-6024, a GLP drug for NASH.

Of course, Merck hasn’t been the only drugmaker to plunge more deeply into ADCs. 

Johnson & Johnson on Monday announced a $2 billion deal to buy Ambrx, a clinical-staged biotech specializing in tubulin payload based ADCs targeting PSMA, HER2 and CD-70. 

The Ambrx deal came on the heels of J&J’s licensing agreement with LegoChem in December to develop and commercialize LCB84, a Trop2 ADC, and also closely followed pharma peers who have waded into the space, including Pfizer with its $43 billion Seagen acquisition, AbbVie with its $10.1 billion ImmunoGen buy and Bristol Myers Squibb scooping up SystImmune’s lung cancer drug. 

For more on the ‘diabesity’ duopoly between Novo Nordisk and Eli Lilly taking center stage at JPM 2024, click here.