Healthcare is Racing to Fight Coronavirus on the Front Lines

The entire value chain of healthcare, from drug development to healthcare delivery, is actively responding to the growing impact of the Coronavirus. As the virus spreads region to region, healthcare is increasingly under pressure to deliver and service the populations affected by the virus.

COVID-19 will require focus from the majority of the Healthcare industry for the coming months. Uncover how these developments are impacting the industry with all relevant commentary from companies across the Healthcare spectrum.

 

Takeaways

• Overall, healthcare companies are unsure of the overall impact of COVID-19 on their business.
• Most healthcare companies are racing to the front lines testing options for a novel Coronavirus vaccine, virtual screening, and expanded testing options.
• Healthcare Technology is focused on business continuity to ensure continued-service for all customers (including those working on vaccines), and providing new technologies for virus detection and monitoring
• Biotech & Pharma is measuring the impact on their supply-chain and some companies are reporting that their China operations are slowly returning to normal levels though concerns linger.  Manufacturers are making alternative plans to source through India and Europe
• Multiple pharma companies have pledged to not use the pandemic as pricing leverage even where API and raw material shortages may exist
• Companies across the healthcare sector are retracting previous guidance and providing updated guidance throughout April.

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Here are the highlights. [Note: We are updating this post and our compilation post daily to reflect the most recent commentary. Last updated 4/5]

 

Iqvia Holdings Inc.  (4/3 – 8K)

Becton Dickinson & Co (4/2 – 8K)

Boston Scientific Corp  (4/2 – 8K)

Centene Corp  (4/2 – 8K)

Quest Diagnostics Inc  (3/31 – 8K)

Stryker Corp  (3/31 – 8K)

Amgen Inc  (3/31 – 8K)

Veeva Systems Inc  (3/30 – 10K)

Mylan N.V.  (3/30 – Press Release)

Johnson & Johnson  (3/30 – Press Release)

Boston Scientific Corp  (3/30 – 8K)

Abbott Laboratories  (3/27 – Press Release)

 

CVS Health Corp  (3/26 – 8K)

Thermo Fisher Scientific Inc (3/26 – Press Release)

Thermo Fisher Scientific Inc. (NYSE:TMO), the world leader in serving science, today announced that it has received the CE mark in the European Union for its diagnostic test to detect nucleic acid from SARS-CoV-2, the virus that causes COVID-19.

“The CE mark certification is an important step in combatting the outbreak of COVID-19 across Europe,” said Marc N. Casper, chairman, president and chief executive officer of Thermo Fisher Scientific. “We are committed to fighting this disease and we will continue to work with regulatory authorities and customers around the world to expand the availability of diagnostic testing and stem the spread of the coronavirus.”

 

Baxter International (3/25 – Press Release)

Bristol-Myers Squibb Co  (3/25 – 8K)

Iqvia Holdings Inc  (3/24 – Press Release)

 Q² Solutions, a leading clinical trial laboratory services organization resulting from an IQVIA and Quest Diagnostics joint venture, today announced its collaboration with the University of Texas Medical Branch (UTMB) to develop a novel assay for COVID-19 (SARS-CoV-2) tests, an essential tool for rapid development of a Coronavirus vaccine. Once a viable assay is developed, Q² Solutions labs will produce it for use in clinical trials to determine the effectiveness of a COVID-19 vaccine.

An assay is an analysis done to determine the biological or pharmacological potency of a drug. Compared with the conventional plaque-based neutralizing assay, UTMB’s novel reporter COVID-19-based test may provide several potential advantages, including increased sensitivity and dramatic increase in assay throughput because the assay time is shifted from multiple days to a single day.

 

Cepheid Inc  (3/23 – Press Release)

The US Food & Drug Administration (FDA) has granted Emergency Use Authorisation (EUA) to United States-based Cepheid’s Xpert Xpress SARS-CoV-2, a rapid molecular diagnostic test for qualitative detection of SARS-CoV-2, the virus causing COVID-19, it was reported on Saturday.

The test is intended to operate on any of the company’s more than 23,000 automated GeneXpert Systems worldwide, with a detection time of around 45 minutes.

 

Humana Inc  (3/23 – 424B5)

The spread of COVID-19, or actions taken to mitigate this spread, could have material and adverse effects on our ability to operate effectively, including as a result of the complete or partial closure of facilities or labor shortages. Disruptions in public and private infrastructure, including communications, financial services and supply chains, could materially and adversely disrupt our normal business operations. We have transitioned a significant subset of our employee population to a remote work environment in an effort to mitigate the spread of COVID-19, as have a number of our third-party service providers, which may exacerbate certain risks to our business, including an increased demand for information technology resources, increased risk of phishing and other cybersecurity attacks, and increased risk of unauthorized dissemination of sensitive personal information or proprietary or confidential information about us or our members or other third-parties. The outbreak of COVID-19 has severely impacted global economic activity, including the businesses of some of our commercial customers, and caused significant volatility and negative pressure in the financial markets. In addition to disrupting our operations, these developments may adversely affect the timing of commercial customer premium collections and corresponding claim payments as well as the value of our investment portfolio.

The rapid development and fluidity of this situation precludes any prediction as to the ultimate adverse impact to us of COVID-19. We are continuing to monitor the spread of COVID-19 and related risks.

 

Thermo Fisher Scientific (3/23 – 8K)

We are subject to risks associated with public health crises and epidemics/pandemics, such as the novel strain of coronavirus that recently originated in China.

Our global operations expose us to risks associated with public health crises and epidemics/pandemics, such as the novel strain of coronavirus that recently originated in China (COVID-19) and has spread globally. In recent weeks, the continued spread has led to disruption and volatility in the global capital markets, which increases the cost of, and adversely impacts access to, capital and increases economic uncertainty. It is likely that the pandemic will cause an economic slowdown of potentially extended duration, and it is possible that it could cause a global recession.

COVID-19 is having, and will continue to have, an adverse impact on our operations, supply chains and distribution systems, including as a result of impacts associated with preventive and precautionary measures that we, other businesses and governments are taking. Due to these impacts and measures, we have experienced, and will continue to experience, significant and unpredictable reductions or increases in demand for certain of our products. Many employers in the United States and Europe are requiring their employees to work from home or not go into their offices. If the pandemic continues and conditions worsen, we will experience a decline in sales activities and customer orders, and it remains uncertain what impact these declines will have on future sales and customer orders once conditions begin to improve. In addition to existing travel restrictions, countries may continue to close borders, impose prolonged quarantines, and further restrict travel, which would significantly impact our ability to support our sites and customers in those locations and the ability of our employees to get to their places of work to produce products, or significantly hamper our products from moving through the supply chain. As a result, given the rapid and evolving nature of the virus, COVID-19 will negatively affect our revenue growth, and it is uncertain how materially COVID-19 will affect our global operations generally if these impacts persist or worsen over an extended period of time. Any of these impacts would have an adverse effect on our business, financial condition and results of operations, and at this point, the extent of the impact of COVID-19 remains uncertain.

 

Johnson & Johnson (3/20- Press Release)

Q: The Covid-19 outbreak is impacting supply chains around the world. Has Johnson & Johnson been affected by any supply chain disruption?

A: Covid-19 is a very dynamic situation, but thanks to the hard work and dedication of our supply chain teams around the world, as of today we have sufficient inventory for patient needs and are working diligently to minimize impact.

We are also monitoring closely both our supply levels and product demand in order to ensure adequate and effective distribution of our products and services.

Q: What steps is the company’s supply chain taking during this Covid-19 pandemic?

A: Most critical is having robust business continuity plans in place across our global supply chain network to prepare for unforeseen events and to meet the needs of the patients, customers and consumers who depend on our products.

These steps include maintaining key inventory at major distribution centers away from high-risk areas and working with external suppliers to support our preparedness plans.

Q: How have similar crises in the past helped prepare the Johnson & Johnson supply chain for Covid-19?

A:Unfortunately, this is not the first time we have needed to mobilize quickly in response to a crisis. It’s part of our 134-year heritage to step forward to help where we can.

 

UnitedHealthcare (3/18 – Press Release)

UnitedHealthcare announced today several updates that provide people and families expanded access to the care, support and resources they need to navigate through this unprecedented time. These actions will expand access to testing and medical care, medication, telehealth services and virtual care including rollout of an innovative, personalized digital platform which includes a symptom checker to help members rapidly assess their risk for COVID-19. The company is also expanding its efforts to engage those people with the highest risk of contracting serious illness.

“In response to COVID-19 we are taking actions to support our members by significantly expanding access to our telehealth, virtual care and digital capabilities for patients and their health care practitioners,” said Dirk McMahon, CEO of UnitedHealthcare.

 

Regeneron Pharmaceuticals Inc (3/18 – Press Release)

Biotechnology company Regeneron Pharmaceuticals Inc (NASDAQ:REGN) stated on Tuesday that it has started a clinical programme to evaluate Kevzara (sarilumab) in patients hospitalized with severe COVID-19 infection in partnership with Sanofi.

According to the company, Kevzara is a fully-human monoclonal antibody that inhibits the interleukin-6 (IL-6) pathway by binding and blocking the IL-6 receptor. IL-6 may play a role in driving the overactive inflammatory response in the lungs of patients who are critically ill with COVID-19. It is being investigated for its ability to reduce the overactive inflammatory immune response associated with COVID-19.

The company added that IL-6 is supported by preliminary data from a single-arm study in China using another IL-6 receptor antibody.

This US based trial will begin at medical centres in New York, one of the epicenters of the US COVID-19 outbreak and will assess the safety and efficacy of adding Kevzara to usual supportive care, compared to supportive care plus placebo. The multi-centre, double-blind, Phase 2/3 trial has an adaptive design with two parts and is anticipated to enroll up to 400 patients.

In conjunction, the first part will recruit patients with severe COVID-19 infection across 16 US sites to evaluate the impact of Kevzara on fever and patients’ need for supplemental oxygen.

 

Laboratory Corp of America (3/17 – Press Release)

Today, the U.S. Food and Drug Administration took two additional significant diagnostic actions during the coronavirus outbreak (COVID-19) by issuing Emergency Use Authorizations (EUAs) to: Hologic for its Panther Fusion SARS-COV-2 Assay, and Laboratory Corporation of America (LabCorp) for its COVID-19 RT-PCR test.

‘Staff at FDA have been working nonstop to expedite the review and authorization of diagnostics during this public health emergency,’ said FDA Commissioner Stephen M. Hahn, M.D. ‘Our device center has been in continual contact with the medical device community, in particular diagnostic developers, since January-providing technical assistance to test developers to help facilitate the availability and distribution of tests so that health care professionals can accurately detect the COVID-19 virus.

 

Vifor Pharma (3/12 – Full-Year Earnings Call)

Question – Emily Field: Yes. And then I know you did mention coronavirus in your prepared remarks. But just — it’s just — and I know you don’t run the dialysis clinics. But just if you would — could just give us any guidance on whether there’s a proper safety procedures in place for all the employees and patients there? Obviously, these are (inaudible) necessary procedures. So one would expect that those are not going to be deferred regardless of how the situation plays out. But just any color there would be helpful.

Answer – Colin Bond: Well, I’ll talk just on the operations, liquidity, FX impact, and then Stefan will talk about the employees. So in terms of the FX impact, first of all, that’s the one that is possible to quantify with the weakening of the dollar and the euro against the Swiss franc. If, and that’s a big if, if the Swiss franc was to stay as strong as it is today against — against the dollar and the euro, that would have an impact of approximately 2% on our top line.

But the like-for-like currency is within our guidance. And then at the EBITDA level, because we do a really nice job of rolling hedging, the EBITDA impact negative would be up to CHF 15 million. But again, that’s if the Swiss franc stayed as strong as it is today for the rest of the year.

In terms of our liquidity, you can clearly see that we are cash positive, net of debt, we have undrawn credit facilities.

In addition to that, none of our debt is repayable until 2022 when the bond is repayable.

So in the short term, we have all the liquidity and financing we need. And we’re going to be very cash positive from the operations in 2020. So we — in terms of the operational — operations, we review this on a daily basis.

We have at least a year of inventory for all of our key products for Ferinject nearly 2 years of inventory. And in all markets, we have approximately 2 months of inventory as a minimum available. And we’re in daily contact with all our carriers and distributors. So we’re doing a really nice job of monitoring the situation, and we feel well prepared to respond to anything that happens. On the employee side, I’ll pass over to Stefan.

Answer – Stefan Schulze: Yes, Emily, it’s Stefan again. I thought you were asking about the procedures with regards to dialysis clinics. If I understand the question correctly, in that sense, I would refer to FMC really. Of course, dialysis providers are used to deal with the problem of patients having infections and they have respective procedures in place.

To the extent, it was referring to our own employees, then we are probably mirroring what many other companies do. We have a management crisis team in place, and we provide our employees the opportunity more and more to work from home across the European affiliates and beyond. So we take all the same measures, as you would expect from a company which tries to slip up to the corporate responsibility.

UnitedHealth Group (3/12 – Barclays Global Health Conference)

Question – Steven James Valiquette: Okay. Great. Yes, that’s helpful. And then from a health care payer perspective, a few other managed care companies at our conference would seem to suggest that investors could potentially just think of coronavirus as an extension of a flu season, which you just kind of touched on a little bit, and that if it did proliferate into next year or next year’s season, these other managed care companies could just reprice for that across some or most of their product lines. So I guess I’m curious whether you share that view conceptually or would you characterize it differently?

Answer – Dirk C. McMahon: Yes. This is Dirk McMahon again. Thanks, Steve. What I would say is, first of all, the main thing as far as coronavirus is, as Doc described, you don’t have a good feel on the penetration rate or the spread rates. So without knowing that, it’s a little bit difficult to handicap. What I can tell you is during a normal flu season, we’ll — and that would be normally from the fourth quarter of 1 year to the first quarter of the next, that 6-month time frame, typically, we would have about $450 million in a normal flu spend over that 6-month period of time. And that’s — we would, of course, price for that, and we plan on that every year. But again, our ability to sort of handicap what’s happening with the coronavirus versus a normal flu season, at this stage, we don’t have enough data to be able to make that determination.

Johnson & Johnson (3/11 – Barclays Health Conference)

Answer – Ciro Roemer: Well, Kristen, thank you for having us. It’s a pleasure for us to be here and represent Johnson & Johnson.

I would say, first of all, Johnson & Johnson being the global health care leader it is, is closely monitoring the coronavirus situation. And we’re trying to take steps to prevent, first of all, help the spread of the virus as well as exploring the potential for a vaccine. I think you know that we have a division in our pharm organization that is very much involved with vaccines in regards to Ebola but also now with the COVID virus.

We understand that the impact of the coronavirus, certainly it’s a devastating health issue. We remind ourselves of our credo, and that’s what’s guiding us at the moment. Just for context, we have provided over 1 million surgical masks across the world. We’re very actively involved with our consumer department, providing enough medicines. I think we donated 11,000 cases of MOTRIN; 50,000 bottles of BAND-AID; alcohol. We’re donating generators and other medical devices to hospitals. And certainly, we have activated our global team of scientists to work on a vaccine and other solutions.

As you can imagine, we’re closely monitoring the coronavirus situation of — an area of impact and interest certainly for you all is manufacturing. Our manufacturing centers are producing medical and pharmaceutical products as we speak. Also in China, to a large extent, we’re back online and producing products. Of course, we’re in close alignment with the Chinese government to ensure that we can continue to provide and supply critical products to our customers.

The impact that we are seeing is more on elective procedures. As you can imagine, in China, Japan and South Korea, the impact has been meaningful. Those procedures are starting to come back online. But I would say they’re not back to historic levels. We’re starting to see a similar trend in certain parts of Europe. And in the U.S., I would say we’re in the early innings of this whole event evolving. We’re — it’s a fluid situation, I would say. We’re closely monitoring it. I think what I can share is that many institutions have told their surgeons and their medical personnel not to travel. I don’t know if you’re aware, but the AAOS made the decision yesterday to cancel their meeting in Orlando. That’s the most important orthopedics congress that happens every year, around 17,000 health care providers join that congress. It’s canceled. It was going to be held at the end of the month. So that’s not going to continue. We expect that large meetings, certainly in March and April, will have a tendency to be canceled.

AmerisourceBergen (3/10 – Barclays Health Conference)

Question – Steven James Valiquette: So let me — just give me 2 seconds here to shift gears. Obviously, coronavirus, major topic around this conference. So we’ll certainly kick off with a few questions around that. And yes, so the shutdown in China, and there’s also been some restrictions from India and a few drugs has created some concerns for investors that drug shortages could occur just due to API shortages. So let’s just start maybe curious to see what you’re seeing and hearing in relation to this? And also, does ABC typically stockpile inventory of certain drugs in these types of situations? I guess we’ll just start there.

Answer – Steven H. Collis: Steve, thank you. And obviously, the coronavirus has had an effect because we would much rather be doing this in person with you and seeing all of our investors and other parties that have an interest in ABC and not having this annoying train in the background, would also be an advantage. But as you would expect, as a responsible company, we’ve been actively monitoring COVID-19 since the outbreak in Wuhan, literally from December when we first got reports of it. Obviously, that’s an important area for chemical and API manufacturing, and we are in constant communication with our manufacture partners. And we have those sort of bilateral relationships and the concern for the mutual customer, the provider customers and ultimately, the patients we serve to plan and analyze to ensure sustainability of supply. So we are monitoring this very fluid situation and trying to be as proactive as we can to make the necessary preparations and investments to prepare for a disruption if one would occur. So as an active participant — ABC is an active participant in the pharmaceutical supply chain. We’re constantly monitoring the situation, and we will continue to work closely to ensure a stable supply chain.

Answer – Steven H. Collis: Yes. I mean, as you correctly say, we can’t say too much. I would say that this crisis, the coronavirus crisis, actually highlights a lot of what we’ve been saying, how important it is for us to be very strong financial companies and to have strong cash flow ability to invest in our business and to continue to grow our business and our relationship with our customers and our relationships with manufacturers. As I said on the earnings call, we are ready and prepared for the upcoming trials, but we also believe that the global settlement framework that we’ve outlined makes a lot of sense for states, governments, the attorney generals, the patients that will ultimately benefit. And we are committed to resolving this because we just frankly think that it’s not productive to continue with litigation. So we remain committed to transparency. And of course, any definitive developments that occur, we will update our shareholders in an appropriate manner.

Humana (3/10 – Barclays Health Conference)

Question – Steven James Valiquette: Okay. All right. And somewhat tied into that, don’t know if you’re able to comment on this or not, but just given your comment on the last quarterly results about 1Q 2020 earnings representing about 24% of full year earnings and recognizing that you’ve already factored in flu seasonality and then so far coronavirus not really changing much, should we assume there’s no incremental impact as far as 1Q ’20? And that guidance you gave around 24% of full year earnings, that still holds the way, the way you see things right now?

Answer – Brian Andrew Kane: Yes, I would say that holds, and we reaffirmed guidance last night or 2 nights ago, whatever, just to that effect. So yes.

Question – Steven James Valiquette: Okay. Great. Okay. Before I dive into a few other parts of the business, I did have one other question I forgot to ask around coronavirus, and that’s really just the concept of having any sort of reinsurance coverage for pandemics, et cetera. Just curious if that’s something that — has that been triggered any time in recent history that you can think of?

And if we also had to compare coronavirus to any of the other virus type situations, whether it’s SARS, MERS, Ebola, you name it, is there any of those that you would say the pulse is parallel to what’s happening this year? So I’m curious to get your thoughts around both those subjects on coronavirus.

Answer – Brian Andrew Kane: I think — yes, I think on the second one, it’s really hard to compare. We just don’t know enough yet, I mean, what the incidence rate is, how prevalent it is, what the mortality rate is, because a lot of it’s unreported still. So I think we got to withhold judgment on that comparing it to other viruses that we’ve seen.

I think with respect to reinsurance, again, I think it’s too early to tell. I think, honestly, it will depend on how severe it is. Other than that, other industries are probably higher on the pecking order than we would be, but I don’t know. We haven’t had those conversations. I think it will depend on how severe the challenge is.

Certainly, people who are unsured, I think, will get — are most likely to get the coverage on this topic. And then industries that are perhaps more systemic in nature that could really impact the economy like airlines, et cetera, might get something. But it’s hard to say on whether the insurance — the health insurance industry would get you reinsurance for an extreme outbreak. I don’t know the answer to that. We’d obviously be supportive of that, but it’s hard to say whether that would come forward.

Eli Lilly Co (3/10 – Barclays Global Health Conference)

Answer – Jeffrey Emmick: This is Jeff. I’ll comment briefly on that. Obviously, we have a pretty significant work stream across the company that’s evaluating the effect of COVID-19 on all of our clinical development programs. To date, most of the impact has been, when it comes to clinical development, has been in China, but that may continue to evolve.

Right now, I can speak at least to tirzepatide. We haven’t had a significant impact on our tirzepatide development program to date. Our China registration program is actually a separate trial being done in China and several other countries across Asia. But we continue to monitor this very closely. Obviously, there’s always the risk of patients actually in the trials having — or coming down with coronavirus. We do have a lot of high-risk patients so we’re monitoring it very closely. But I think we’ve got the right resources around this.

There are opportunities for us to — we’re allowed to get study drug to patients even if they can’t come into the office, for example, and I will be working closely with regulators as well on addressing any gaps in data or patient visits, et cetera. But we feel pretty confident that we’ve got a solid plan around continuity when it comes to clinical trial operations.

 

Quest Diagnostics (3/10 – Barclays Global Health Conference) 

Question – Jack Meehan: Just wanted to start, Mark, with the here and now obviously, the topic de jure has been the coronavirus. I was curious if you could weigh-in just how you expect this to impact the business and demand for testing services and have you seen any increased testing rates so far related to the new test?

Answer – Mark J. Guinan: Right. Thanks for the question, Jack, and pleasure to be on the phone here. What we’ve shared publicly is that we started yesterday with specimens collected yesterday in California, at our Esoteric Lab in San Juan Capistrano, we’ll be ramping up capacity. There’s a validation process across multiple pieces of equipment and then across multiple sites. It’s going to take us several weeks to maximize our capacity through that validation process across the 2 Esoteric sites and then some — we do have some of that equipment, we’re using in some of our regional labs, and Steve shared yesterday in an interview that within several weeks, we expect to be able to do several tens of thousands of tests a week.

Now we’re all speculating. So I have no idea what demand will be. But based on the discussion that took place in D.C. last week with the Vice President — or with Secretary Azar, the sense is that the demand could far outweigh capacity even with us and our — the international lab and multiple regionals and hospitals all ramping up as quickly as possible that it is a race to increase capacity. So we’re not in any way, sizing this, and saying, we think we’re going to get x, and therefore, we’re only going to create so much capacity. We’re going to create as much capacity as we possibly can as quickly as we can. And then, obviously, monitor the incidence rate and see if we need to slow that down, but we’re not at all being cautious.

The next phase, Jack, would be likely, there are several IVD manufacturers who have suggested they have some kits that would be available as well. We’re probably a couple of weeks away from those. If that ends up being accepted and validated, then the next step of capacity would be acquiring some of those kits in addition to the laboratory-developed tests that we’ve already put up and got approval for it through emergency use.

So that’s kind of where we’re at. We’ve shared a couple of instances already where we can’t size this. We’re not going to predict how much testing we’re going to ultimately do. It’s unpredictable. And that we do think there is potential for an offset on utilization because society seems to be changing behavior around certain things. We’re not having this conference in person. That’s a prime example.

And so one could imagine that some people might choose to engage less with the health care in structure for concerns around catching something in the office and the waiting room from the doctor, et cetera. We don’t know. And we’ve already had a couple of investor 101s this morning. I’ve been asked certainly, we don’t share mid-quarter updates. However, if there was anything material that we’ve seen a change in our business, we’d feel obligated to share something. And again, we don’t know. So one thing you might think about is our average patient counter, which is our acquisition is the mid-$40 range. Certainly, the coronavirus reimbursement should at least cover that, if not be a little higher. And so you’d say a one-for-one swap would be about even, but we don’t know how many people is going to be one-for-one and office visits replaced for a corona visit. And then the other question is mix. If people who don’t engage are skewed toward healthy annual wellness check. Certainly, we do a lot of tests in those — the whole battery of chemistries and lipids and blood count and so on, how our seniors are going to react. Seniors consume more of our business. So are they going to be more or less likely to go the doctor, one camp can say, “Hey, for the smallest sniffle, they may rush in because, obviously, I want to get — seriously, I only want to get in-treatment quickly.” And the other thing is they’re the mostly at risk. So therefore, maybe they’re going to mills cautious. We don’t know. So all we can share is some of our thinking, but we can’t quantify any at this point. We just want to acknowledge that. Like other industries, we think that there could be some potential for negative impact to our business if people change their behaviors. However, unlike many other industries, we also will do some testing specifically related to corona.

Teleflex (3/10 – Barclays Global Health Conference)

Question – Kristen Marie Stewart: Obviously — yes. Obviously, the big topic all around here has been coronavirus, the reason why we are virtual today. You’ve said that basically, the amount that you included within your guidance thus far has been a $5 million to $10 million impact. I was wondering if you could kind of talk with us just about any updated forecast you may or may not have? Or just kind of thinking, as you’ve seen the virus spread through different geographies, just how you’re thinking about that today?

Answer – Liam J. Kelly: Yes, thank you. So you’re correct. Yes, we have $5 million to $10 million in revenue in Q1 and an impact of $0.05 to $0.10 associated with the coronavirus. That is based on what we saw when we gave our guidance for the year, and it’s included in our guidance. And it was really the impact that we saw in China. The lower end of that range would have been if China get back to normal in early March. The upper end of that range is contemplated that China gets back to normal in April. Now what we are seeing on the ground, we have 1 small manufacturing plant in China, that has been up and running now for about 10 days and running pretty well. Our office got back to a pretty normal working conditions over a week ago. So yesterday week, our people went back to work in the office. And 2 weeks ago, the individuals that had left Shanghai — so 2.5 weeks ago, in a population of 20 million people, there were only 10 million people living in Shanghai. Two weekends ago, all of those individuals returned. So now there’s 19 million people. Obviously, Hubei is still in lockdown. So the travel was restricted there. But our people tell us that things are slowly starting to get back to normal in Shanghai, which is probably a good indicator for at least the Eastern seaboard, where most of our products are sold and our expectation is that as we go through the month of March that Shanghai, Beijing and large cities like that will get back to some semblance of normality.

 

Cardinal Health (3/10 – Barclays Global Health Conference)

Question – Steven James Valiquette: Okay. Great. And also thanks for your flexibility around this whole coronavirus situation. And speaking to that and also to dive right into that, certainly, it’s top of mind for a lot of investors, so a few questions around that as it relates to the pharmaceutical supply channel. First of all, the shutdown in China has created some concerns that drug shortages could occur just due to API and bulk material constraints. Just curious if you guys were able to discuss what you’re seeing right now in relation to that. And also, I mean, in these situations, when Cardinal and drug distributors perhaps try to stockpile some inventory of key drugs, that you’re anticipating some shortages. So let’s just start around that dynamic first.

Answer – David C. Evans: Well, Steve, thanks for having me on the phone, and thanks to everyone joining us. Yes. The coronavirus definitely had its impact across many different ways. One thing I do want to make sure I start with, just because I think it’s really important for everybody to know, is besides focusing specifically on our M and P segments related to the impacts of it, we also, as a company, have been working on this now for over a month.

As it relates to our own business continuity, with each one of our distribution centers, manufacturing centers and our headquarters to make sure that we have backup systems in place, testing, working at home, backup players to be able to make it into our distribution centers because we have a higher standard of requirement to make sure that our customers get drugs or medical supply. So I just want to make sure to let everybody know that we’re not only looking at our products that we sell but our own people, safety of them and making sure we can get products specifically to our customers.

As far as on the P segment and the tie-in to the coronavirus, we do — we had anticipated this a while back. So when we first saw it in China, our Red Oak team immediately began looking through our database to see where we either had finished those, which are very little coming from China, but more importantly, where there’s any raw materials coming from, in particular, the Wuhan province, where was ground zero for this.

There are some raw materials at a nearby province. So knowing that, we did stock up on some extra inventory on key products that had raw materials coming from that area very early on to make sure that we understood that we — what was going on, that we could have some extra. We’ve done this as it’s moved around the world. We constantly use our database to understand if we’re going to have any finished good or raw material problems with any of the pharmaceutical items.

So we looked in Italy, when it began in Italy, et cetera, and we continued to adjust our inventory where we can get extra product to stock up to make sure that we’re staying ahead of it.

The good news is, through our conversations, and I’ve had a few myself directly, most of the manufacturers are carrying a few months’ worth of inventory on hand. So I feel like, at least for the next few months, we should be fine to be able to get the majority of items that we need. Now if this were to extend past early summer, then I think everyone’s going to be looking at some potential supply disruptions not only because of the API materials, but — one of the other piece that’s harder to track because there’s so many of them is key starting materials or KSMs, so the items that go into the manufacturing of the API. Some of those are — have some potential disruptions, and so some of the suppliers, again, are keeping their eyes on those, but tell us so far that they hold several months of APIs and finished dose stock and KSMs and we should — that we should be okay for a few months.

Question – Steven James Valiquette: Okay. Great. Now at the same time, where there’s some risk of API shortages, there’s also some price increases happening on API. And I know from tracking that side of the industry, prior times in my career, I can almost guarantee it’d probably be in pass-through by a lot of the finished dose drug manufacturers as well, whether it’s brand or generic, but probably more on the generic side.

So I guess, I’m curious how is that being factored into the company’s view on the generic market and spot prices within the market? And if there is generic inflation, I’m curious if you’re seeing that, and that would obviously help to offset — I mean, that’d be a positive for a drug wholesaler, would help to offset some of the risk of volume shortages. Just curious how you’re viewing on the pricing side.

Answer – Michael C. Kaufmann: Yes. It’s a good question. I would say, so far, we’ve not seen any material price increases that I would say are related to the coronavirus yet. There are manufacturers that are starting to see some price increases on API. And as you know, we’ve talked about this in the past. Our goal for Red Oak is to never take any price increases. So we’re always going to fight aggressively to make sure that we’re getting after the low cost. Now there are times when you sometimes do take them if it’s the right thing for ourselves and the supplier. And when we do, we are typically able to pass those price increases through to our customers, and the goal there being to maintain our sale margin per unit.

Laboratory Corporation of America Holdings (3/10 – Barclays Global Health Conference)

Question – Jack Meehan: Great way to start. I wanted to focus on kind of the here and now, the topic de jure is, obviously, the coronavirus. I was wondering if you could give us an update on how you expect the outbreak to impact the testing rates in your Diagnostics segment. And then just remind us of the operational exposure within Covance.

Answer – Adam H. Schechter: Sure. So first, I’ll start off again by saying, I couldn’t be more proud of the LabCorp team, particularly our scientists and our operations teams that have been able to get a test up and running in the marketplace for the novel coronavirus. And we started to take orders and receive samples, Thursday, 6:00 p.m. of last week, and that continued through the weekend and through yesterday. And we believe that we will continue to do everything we can to build up our capacity as we move forward.

In terms of impact, as I mentioned on the fourth quarter call, we believe that the range that we’ve given for guidance will cover what we currently believe the impact would be from the coronavirus. So there will be some pushes and pulls. We give annual guidance, we don’t give quarterly guidance. But I do believe that there will be some things within the quarter that may occur, particularly when you think about our central lab in China, for example, where we had quite a backlog as China took an extended holiday through the New Year’s, and therefore, that laboratory had a backlog. We’re trying to work through that backlog. People are back to work in the laboratory. But whether that happens in the first quarter or second quarter is yet to be determined.

In addition to that, in some of Asia, but also in certain parts of Europe, we’ve seen clinical trial enrollment slowed down for a period of time. And we still have to wait to see the impact of that as we continue to see the coronavirus in other countries in the world, but we do believe that there may be some impact there. If you look at the diagnostic testing that we do in the United States, we haven’t seen any significant impact of the number of tests or type of tests as we sit here today. But of course, we’ll be watching that very closely. And when you start to think about people going in for wellness exams, for example, we’re going to adopt this for routine testing. That might slow down a bit even as we see coronavirus testing go up a bit in the diagnostic area in the United States.

Centene Corp (3/10 – Barclays Global Health Conference) 

Question – Steven James Valiquette: All right. Great. So since coronavirus is certainly top of mind for probably most investors right now, let’s start with a couple of questions related to that.

Last week on your conference call, you guys sort of articulated, there has not really been any big uptake in utilization at the time as a result of coronavirus, and it was essentially business as usual, I think, was the — like the general phrasing.

But the world is kind of evolving pretty rapidly here day by day. And I think as people in many parts of the U.S. now are focusing on, let’s call it, personal conservatism. I’m curious if you’re seeing any signs that maybe there’s less utilization of the U.S. health care system overall? Maybe we’ll just start high level there.

Answer – Edmund E. Kroll: Well, it’s still early, Steve, I know you know that. And we’re still in a process of — we’re ready, we’re reaching out to the various constituencies. I think as we said last week, we feel like we’re well positioned for a situation like this, given the local approach that Centene has always had to managing populations in the markets we participate in. So I would say, again, prefacing it by saying, it’s still early. We haven’t seen a change from the comments we made last week on the March 4 call, where we did the 2020 guidance. And we — I’ll just throw a couple of the other data points out there that we highlighted last week on this topic.

Greater than 80% of the cases that have been out there so far on the coronavirus are mild. And as far as populations go, the older ones seem to be the more vulnerable at Centene, which includes WellCare. We’ve got 94% of our combined population — patient — membership population, 94% younger than 70 years of age and 45% is less than 20, given our big participation, #1 market share in Medicaid, especially the TANF and the CHIP populations.

Varian Medical Systems (3/9 – Conference Call)

Thank you, Anshul, and thank you all for joining us. Today, we announced that the COVID-19 outbreak will negatively impact our operating results.

Across the company’s Asia Pacific geographies, health care resources are being prioritized for the treatment and management of the outbreak. Consequently, we are experiencing delays in hardware and software installations and acceptance as well as in delivery of interventional oncology procedures. While no orders have been canceled, we expect revenues to be negatively impacted. And as of today, estimate second quarter of fiscal 2020 revenues to be in the range of $800 million to $825 million. While uncertainty remains around the duration, severity and geographic scope of the COVID-19 outbreak, we preliminarily estimate 7% to 9% revenue growth for fiscal year 2020.

 

Regeneron Pharmaceuticals (3/6 – J.P. Morgan Biotech Conference Call)

Question – Cory William Kasimov: All right. Thanks, Matt. So we didn’t intend to ask many questions beyond IO with regard to the pipeline on this call, but just given the circumstances, everything that’s happening in the world, I did want to ask you on COVID-19. And maybe if you could just remind us what Regeneron is doing on this front? And when we could potentially hear more about your efforts?

Answer – Justin Holko: Sure. Thanks, Cory. We — as you can imagine, we do have a lot that we are doing in this space. Just to rewind a little bit, we do have a proven track record as it pertains to responding to these outbreaks of infectious disease. Back in 2012, we responded to the call with MERS. We most recently spoke about the fact that we have what looks to be a potentially curative cocktail against Ebola that was found to be superior to other therapies and that readout in last August. And so you can imagine that the team here is very much focused on this as it pertains to the new — the COVID-19, SARS-CoV-2 outbreak.

 

Cooper (3/5 – Q1 2020 Earnings Call)

 Having said that, Asia Pac is already rebounding, and we expect growth in Q2, even in the face of the coronavirus…  Our business in China is relatively small, only roughly 2.5% of our revenues, and we have no manufacturing or packaging located in the country. So that’s obviously helped.

We have been able to maintain or supply of product in China, which is sold through third-party distributors. So the impact has largely been around the parts of our business that sell into hospitals. That being fertility and our specialty lens business.

We’re also seeing a modest impact in other countries where there’s heightened virus activity, but our businesses are proving to be relatively resistant. At this point, we’re estimating the total revenue impact in Q2 will be roughly $15 million, comprised of $11 million in CooperVision and $4 million in CooperSurgical. I believe we’ll likely claw some of this back as we move through the year, but we’re not including that in guidance. Having said that, we’re holding our full year revenue guidance unchanged, driven by the improved MyDay production and new contracts we’ve won in our fertility business, which we expect to generate higher sales in Q3 and Q4.

Underlying all this is the assumption, our global operations largely returning normal in May, the beginning of our fiscal third quarter. Brian will provide additional numbers, but our expectations for a strong year remain intact.

 

Merck (3/5 – KGaA Full Year 2019 Earnings Call)

We are looking into more or less applicable historical models of other crisis. We have determined that these crisis, be it precision, be it the disease threats have an industry-specific impact, which we must take into account that we’re now sharing with you a scenario, which we have developed in mid-February on this Slide 26.

Under this scenario, we assume that the COVID-19 outbreak peaks in Q1, eases in Q2 and that the situation is sort of back to normal in the second half of the year. In total, this scenario translates into a drag on our full year sales of around 1%, mainly coming from China and mainly occurring in Q1. And this is already reflected in our qualitative outlook for 2020. However, should the effect be significantly more pronounced or should the crisis result in a global recession, please note that this guidance would need to be adjusted, and we can probably go into more detail during the discussion?

 

Align Technology (3/4 – M&A Conference Call)

Question – Kevin Caliendo: I just wanted to go back to the reiteration of the 1Q guidance because I think it’s a relief to a lot of investors that you’re able to do that. And as you mentioned in the context from when you gave guidance, you’re really the first company to talk about the impact of COVID-19. It would imply if things got worse in Japan, things got worse in Korea, these are key markets for you. Things certainly went from 0 to bad in Italy, another market you’ve called out as being an important growth driver. Are we to assume that either China wasn’t as bad as maybe what you originally thought? Or is it just there’s strength in other markets that have been able to offset what we would anticipate being sort of less than what you might have guided for in some of those other countries?

Answer – Joseph M. Hogan: Hey, Kevin, it’s Joe. Look, we wanted to give you that guidance because we knew that would be top of your mind right now because we were first in, and then we had to take our best estimate in the sense of where we are. And we’re really confident in what we told you. As it stands today and what we see, we hold with our first quarter guidance. I don’t want to do any more granularity right now about where it’s coming from and how it’s going on or how we call China or whatever because it’s just an incredibly fluid situation. So please just take our forecast for what it is and the confidence we have behind it. And we’ll certainly update you as soon as the quarter closes.

 

Veeva (3/4 – Morgan Stanley TMT Conference)

Answer – Stan Zlotsky: Got it. And maybe just stepping back a little bit. We’re asking all our companies at the conference this year in light of everything that’s happening out there in the world and coronavirus really in the headlines, how does it affect Veeva? And not even Veeva specifically, maybe even just the industry that you serve more broadly.

Answer – Peter P. Gassner: For the industry we serve, it’s a busy time and it’s a time of change. There’s — they do a lot of collaboration around the world. Some of them are fine-tuned already to do that in a virtual way, such as Veeva. Some are less so. And with the — some of them are decreasing travel, and so they’re having to get better about doing virtual communications. We’re helping many of our customers by providing Engage Meeting, one of our products for the pharmaceutical companies to engage remotely with health care providers. We’re providing that free of charge until September, and that’s helping some of our customers.

We have certainly some customers that are working on treatments and vaccines for the COVID-19 virus. So they’re certainly very busy. And I felt — I read that this morning, Moderna, one of our customers, actually introduced the first candidate for a vaccine. So they’re very busy.

For us, for Veeva, we’ve operated in a virtual way quite well for many years here. We just embrace the virtual technology. We haven’t seen projects canceled. We’ve seen some delays in some projects, but nothing that would materially affect our financials. So we’re continuing to focus and to be productive and to run virtually in the places where we need to where there’s a serious outbreak.

 

Abbvie (3/4 – Cowen Healthcare Conference)

Question – Stephen Michael Scala: Okay. We’ve been polling the audience here at the conference about the COVID-19 situation. One of the questions we’re asking the audience is whether or not they expect the U.S. to go into a recession or even a depression, and the majority of audience participants have said no recession is expected. But refresh our memory on how the aesthetics business works or has performed in less vibrant economic times.

Answer – Michael E. Severino: Yes. I’ll go ahead and take that. So I think the best model that you can look at or the best analog that you can look at is the Great Recession that occurred, obviously, a little more than 10 years ago now. Now what we saw was a temporary slowdown around the time of that recession, which was obviously quite a significant event, but a very rapid return of that warehouse demand, if you will, to levels that match the trajectory that you would have expected had the preceding growth continued. So we see that it’s a pretty resilient business.

 

Centene (3/3 – Guidance and M&A Conference Call)

Before I turn it to Jeff, I want to say a few words about the novel coronavirus, given that it is a focus of many health officials today in the U.S. as well as globally. Needless to say, we are monitoring the situation closely. The situation is fluid. However, we have not seen any impact on our business thus far. It is too early to make a determination given how quickly this could evolve. We do fully expect it to be manageable. Our focus has been on business continuity programs to ensure we’re able to deliver the high-quality care our recipients have come to expect.

Question – Rivka Regina Goldwasser: I understood that the corona — on the coronavirus, it’s still very early. But as we think about the potential implication, I know that Cuomo said — announced plans to waive all payment for all medical expenses related to testing and emergency department care. So if you can just help us kind of like think through potential implication going forward. Should we see — is this something that states would reimburse you or adjust rates for after the fact? Or how should we be thinking about potential financial impact? And if there’s anything historically like H1N1 outbreak that we can use to draw some parallels.

Answer – Michael Frederic Neidorff: I’ll start, and I have some of our medical people on the line, so they can add to it as necessary from a technical standpoint. We’re viewing this virus at this point in time, we have had a flu season every year and some are milder than others. This one right now has been pretty normal, and it has the potential for being a little more severe. And there’s a lot of anecdotal evidence, not our specific evidence. You have anecdotal evidence where doctors, when they get a call from the patients are saying, “Well, probably — look, it’s like a bad cold. So come in, we’ll give you a prescription as needed.” Because they don’t want to expose a lot more people to it. So we’ve not seen a big uptick as a result of this.

Now there are some requirements by states and others to pay for testing, and that’s normal course of business for us. However in this case, my concern is there aren’t a lot of tests available, it’s undersupplied.

So I mean — so I guess as we look at it, it’s business as usual at this point. We have, in our planning, a flu season sometimes, as I said, it’s greater or lessened. If there were some pandemic or some very severe thing, we do have the opportunity to always go back to states and say, “We think it’s appropriate to consider a rate adjustment because of the severity of something.” So right now, it’s business as usual.

Question – Sarah Elizabeth James: Okay. Can you help us think about the risk of the coronavirus in your Centurion book specifically? So is there a potential for higher spread in that type of environment?

And I’m not sure what the age or acuity in that population is. But if there are any issues, do you guys have reinsurance? Or is that the type of contract where you can go back to the states and renegotiate if possible?

Answer – Michael Frederic Neidorff: I think any of these contracts, we feel very comfortable going back. I mean, when the hep C vaccine came out, and things which were exceptional, we went back to the states. And hep C’s hitting a higher incidence of it in that environment, and a lot of them. So we went back and successfully discussed it. And sometimes, we carve out some of that.

It’s hard to say at this point in time. [This flu’s] — we’ve not seen various incidents where it’s greater in that population, in the population at large. And so it’s the type of thing — I would expect it to be normalized, [it hasn’t been confined]. But a lot of us are confined to our offices and other locations where flu spreads. So it’s very similar, I think, as we think about it.

 

Veeva (3/3 – Q4 2020 Earnings Call)

Question – Hoi-Fung Wong: The first thing I want to touch on, I’m sure everyone is following it in the headlines, but obviously the impact of coronavirus and any headwinds you might be seeing in China. I guess, first, just again, what are you guys maybe directly seeing or projecting? And then second, as it relates to your customer base, how should we think about the impact to their business? Obviously, there’s probably maybe some tailwinds as well there and how that might flow through for you guys.

Answer – Peter P. Gassner: All right. This is Peter. I’ll take that one. First, our hearts go out to the people, the families that are seriously affected by this. And we hope they have a speedy recovery.

As it goes to our customers, they’re really working hard to try to develop things that will help the situation, vaccines or cures, actually for this. And we’re helping our customers where we can, but we know they’re working around the clock.

In terms of our business, we haven’t seen project slowdowns yet. We haven’t seen any projects canceled. We’ve seen a little bit of slowdown as customers adjust to working remotely in some regions, nothing that would be material to our financials.

In terms of Veeva, in the countries that are heavily impacted where we have offices, we’ve instituted a work-from-home policy. Now for Veeva, that’s very normal. We handle video conferencing very well. We grew up as a very virtual company so I believe we’re well positioned to handle this.

One of the things that we’re doing, I mentioned on our script, is helping the industry by providing free Veeva CRM Engage Meeting licenses to our customers up until September. That way, they can continue their interactions with the doctors that they need to and they can do that remotely.

So in summary, our customers are working hard to provide the medicines here. There’s no material impact to our business at this time.

 

Teleflex (3/3 – Raymond James Conference)

So as we see our $5 million to $10 million, it will be at the lower end if things get back to pretty much business as normal in China right about now, in early March. The impact will be $10 million — $5 million and $0.05, $10 million and $0.10 on the EPS if the uncertainty continues in China and procedures don’t get back to normal in — until the end of March, early April. I guess where we’re a little bit insulated is the portfolio that we sell in China and also there is, ironically, a little bit of upside also baked into that $5 million to $10 million, where we would envision that some of our CVC coated catheters would get used as some of these patients would get admitted into the intensive care unit because of the condition. And I think that once people return to work, which from our intel, at least, is happening right about now, one would imagine that the procedures would then start flowing through the hospitals. Again, I’m — at least by the end of the month, we’d get back to business as usual. Now the virus has gone beyond the shores of China, as we all know, and is now having some impact in South Korea and Italy. And I think that it is tragic, and I’m not trying to take away from the tragic nature of it, and it is quite infectious, but I would also remind the audience that the general flu in America, just in America, has had 16,800 fatalities already this year in the general flu, and the coronavirus has also tragically had 3,000 fatalities. I think also coming outside of the Chinese health care system moving into a more developed health care systems, like you have in Western Europe and in the Americas, we should be better prepared to contain the virus as long as we’re diligent.

 

Intuitive Surgical (3/3 – Raymond James Conference)

But you look at China specifically, on the procedure side of our business, roughly 3% of our worldwide procedures are performed in China. And yes, they’ve been growing very well as of late as new systems have been installed. There’s no doubt that the coronavirus has been affecting procedure volumes in China and likely had some impact on other countries around the region as well. We’ve seen incidences of outbreaks in Korea as well as Japan and lately, more lately in Italy and even here in Washington state. So it’s really we’re unable to predict what the ultimate impact will be, but clearly there has been some. And we’ll keep you informed as things go.

Yes. I mean we can see differences in trends, and we track them on a regular basis. We’re not going to report here to this group exactly what we see at this point in time because, again, it is very dynamic, and you can look for an update on — after our Q1 earnings.

 

Alnylam Pharmaceuticals (3/3 – Cowen Conference)

I mean, we’ve done — obviously, as all companies are doing right now, done a systematic review of our supply chain in light of the COVID-19 epidemic, and we are in a very good position. We don’t see any implication for our commercial or clinical products. Most of our — we do no drug substance manufacturing or drug product manufacturing in China. And we do that in either the U.S. or in Europe as a company. And we have no — we have sufficient inventory of all of our commercial products as well as clinical development programs as well. So there’s no supply chain implications. Now turning to specific markets and where there might be issues, thus we can talk about Japan. Japan is a big market for us. It probably will exit 2020 as our second largest market. So far, we haven’t seen any implication of the COVID-19 epidemic in Japan.

Question – Ritu Subhalaksmi Baral: On demand?

Answer – John M. Maraganore: On demand. We obviously look at that closely, and we’ll monitor that very closely. But Ritu so far, so good on that side of it.

 

Moderna (3/2 – Cowen Conference)

And of course, we announced a few weeks ago that we shipped to the NIH or coronavirus vaccine for the NIH in the first Phase I.

The last one I’m going to go quickly on it because it has been massively covered is the corona vaccine. So this vaccine’s quite interesting. We have been working with the NIH on the Middle East respiratory syndrome in preclinical models. And so we were quite familiar, the NIH and ourselves, around coronaviruses. We had great preclinical data, including neutralization using the Spike S protein. And so as soon as the sequence was available from China, working with the NIH, we were able to pick a sequence, and the team is moving quite remarkable. In 42 days, we went from the day we pick the sequence to the day we ship the vials to NIH, and that included 2 weeks of sterility testing on the back end. So just to give you a sense of the speed that you can accomplish with a platform like Moderna given the investments we have made in GMP over the years. So the product is with the NIH now. The IND has been filed. And so the NIH will communicate when they start dosing, which will be pretty soon, we believe.

 

Stryker (3/2 – Cowen Conference)

Yes. So first of all, thank you, and thank you for everybody for coming here today. It’s obviously still a very fluid situation, and it’s going to remain so. I don’t think there’s anything magical about the end of the quarter that will suddenly make this disappear.

We have about 2% of our revenue comes from China. We have 3 manufacturing facilities there. They are all opening up and running, but they’re not at full capacity. And clearly, a lot of — essentially, all elective surgeries in China have stopped. And so there will be a revenue impact, certainly, in Q1. We would imagine there’ll be still an impact in Q2 as well as an earnings impact. And I think we have to wait and see how it plays out in some of the other countries like Japan, for example, as well as in the U.S., but we will call that out in terms of this is what we believe the coronavirus revenue and earnings impact is. You can see an adjusted, adjusted number, similar to what we’ve done in the past, whether we’ve had these extraordinary events, whether it’s natural disasters or something like this. So we’ll be able to call it out and give people a sense of the impact.

 

Illumina (3/3 – Cowen Healthcare Conference)

Question – Doug Schenkel: All right. Great. Thanks, Francis. Maybe to kick off with a topic that’s at the forefront of all of our minds right now, and we’ve been asking everybody. We’ve done these discussions with over the past 2 days to comment on COVID-19 and what your — really what your business exposure is from a revenue risk standpoint, at the supply chain positioning perspective, how you’re positioned when it comes to supply chain and then also what opportunities that you found to be helpful and I would think, in your case, moving along with diagnostics and monitoring of the outbreak?

Answer – Francis A. deSouza: Sure. As you can imagine, COVID-19 is [doubling] for us, and there are a number of a number of aspects that we are monitoring closely. First and foremost, we want to make sure that our employees are safe, and so we’ve put into place programs to make sure that they stay safe. For example, in China, our employees are working from home. We are limiting travel, certainly, to some regions in the world. But in general, we’re limiting travel to sort of business essential travel.

The other thing we’re doing is monitoring our supply chain and our ability to continuously serve our customers. The reality is we don’t really do manufacturing in China. And as we’ve gone through our suppliers, we have a small number of suppliers out of China. At this point, they are continuing to able to supply to us. In addition, we’re monitoring our ability to deliver our products to customers in China. And at this point, we’re still able to do that. We are dispensing for certain types of products to be distributed within China, and we fall within that category.

The other change that’s taking place is the 5% tariff that had been imposed on our hardware going into China has been removed. And so that’s played out over the last few weeks.

From a business perspective, we expect that the majority of the impact from a revenue perspective in Q1 to be in China, and we’re monitoring that closely. And as you know, it represents about 10% of our business.

And there are a number of things playing out. One thing that’s playing out is that the authorities in the Chinese CDC are using our sequencers as part of managing the outbreak. And so some of you may have seen the photo in the Chinese Daily of the iSeqs in — but it’s iSeqs, it’s MiSeqs, it’s MiniSeqs that are being used as part of managing the outbreak. And so on the one hand, we expect some impact from increased use of sequencing in that application, which historically has not been a big application for us. We expect that there may be some prebuying by customers taking place. On the other hand, it could be that there is an impact where people don’t go into hospitals to get routine testing. And so we’re monitoring to see how those puts and takes play out, and we’ll update you as we have more information.

Question – Doug Schenkel: Recognizing this is no longer just a China challenge, is it just too early to even have a handle on how this might impact business in places like Italy and South Korea and some of the other places where the outbreak has been a little bit more pronounced over the last week or so?

Answer – Francis A. deSouza: Yes, it’s too early at this stage. The dynamics we expect will be similar. There will be increased use for infectious disease monitoring. In fact, I think once we get through the COVID-19, I think you will see this potentially as a catalyzing event to say we truly do need a global surveillance network that will watch for naturally occurring viruses like we’re seeing right now, but also for things like antimicrobial resistance or potentially even bioterror.

And so I think there is an awakening in the — certainly in the infectious disease community around the need for a global surveillance network long term. So I think as we come out of that, there will be more of a conversation around that.

In terms of impact in those countries, it is too early, and I think you’ll see the same dynamics, increased infectious disease, a question about whether the hospital capacity is there for routine testing.

 

Hologic (3/3 – Cowen Healthcare Conference)

Question – Doug Schenkel: So just to set this up, again, we’ve started most of our discussions at the conference with a question on COVID-19. For you guys, China represents only about 3% of sales. But I am curious, what were you expecting for revenue growth in China?

Answer – Michael J. Watts: Yes. Our international business, as you know, Doug, has been growing kind of at a high-single digit, low-double-digit rate. And China has been in that ballpark, depending upon the quarter. So pretty consistent with the rest of international. I mean, clearly, that will be affected by what’s happening over there now, but we haven’t yet quantified that. And at 3% of revenue, hopefully, it’s pretty manageable.

Question – Doug Schenkel: Okay. Is there any China supply chain, either direct or indirect, that we need to be thinking of?

Answer – Michael J. Watts: Yes. I would say, minimal. I think we’re — certainly, no direct impact we did in recent days and cover a little bit of indirect impact on some of our smaller products, mainly our bone density products and ultrasound products. But it should be okay in the near term. If things continue to stay challenging there for longer term, it would be something to keep an eye on in the second half, but pretty minimal.

Question – Doug Schenkel: Yes. It’s been interesting over the course of this week and checking in with folks over the last couple of weeks that, that indirect supply chain is a little harder for a company…

Answer – Michael J. Watts: It does. It takes a little bit longer to uncover those things. But again, in our case, we think it’s pretty small.

Question – Doug Schenkel: Okay. So beyond China, because unfortunately this is clearly moving globally, what’s the opportunity and pathway for Hologic to actually provide a solution, a diagnostic for COVID-19?

Answer – Michael J. Watts: Yes. I think we — we’re in a pretty good position to help with the public health threat as we did with Zika a few years ago.

Question – Doug Schenkel: Yes. You’ve done this before.

Answer – Michael J. Watts: I mean we’ve done this before, as you say. I think there’s 2 primary paths for us, Doug. One is, we are developing a test for the U.S. market under the EUA procedure, so Emergency Use Authorization, if you’re not familiar. Moving as fast as we can on that in consultation with the FDA and hopefully to — hopefully expect to make that filing within the next few weeks.

Secondly, one of the things that may not be immediately apparent is on Panther Fusion. Remember, Panther Fusion has an open-channel capability. So labs will be able to develop their own tests on Panther Fusion in an automated, high-throughput fashion if they so choose. So probably 2 ways that we can help.

Question – Doug Schenkel: Can you help provide guidance for folks to develop an RUO-based, PCR-based tests to run on COVID-19?

Answer – Michael J. Watts: Yes. I believe there have been protocols that have been published.

Question – Doug Schenkel: Okay.

Answer – Michael J. Watts: So that will be up to the labs obviously to take a look at those protocols, adopt as they see fit, but that can be done under the CLIA regulations.

Question – Doug Schenkel: Okay. And then so that’s a pretty unfortunate but exciting way that you can help and hopefully drive some volume. On the flip side, yes, I haven’t thought about this as much with you guys as some of the other diagnostic companies we cover. But in previous years, yes, there are companies where they will actually see a decrease in volume forecast because people just aren’t going to hospitals or even their PCPs as much if they don’t have to. Is that something we should be thinking about right now?

Answer – Michael J. Watts: Yes. I think that’s certainly a possibility. We have seen that in the past with some really difficult flu seasons, for example. And given that some of our business is basic screening and well-woman checks, I mean that’s certainly a possibility. And we would not expect obviously a significant upside from our own test development efforts on this at all. It all depends on the severity of disease, how long it lasts, how much testing is done. But there certainly is that potential for visits to be hit on the negative.

 

Zoetis (3/3 – Cowen Healthcare Conference)

Question – Well, that’s thankful for all of those with pets. So — and then just in terms of a demand perspective, can you comment what you have seen since the beginning of this year, both in China or anywhere else, impacting demand both on companion animal and livestock?

Answer – Kristin C. Peck: Sure. I mean from a revenue or from a demand perspective, there are 2 main things that we’re watching at least at Zoetis. One is with quarantining and people being nervous to get out that much. We are seeing a reduction in overall vet visits. What remains to be seen is that’s a temporary thing. And then once the quarantines are lifted and people feel comfortable traveling, they’re making up those vets visits. But even if they are, they might not necessarily be making up those doses of antiparasitics and things like that, that they would have used. So we do see — one thing we’re watching is just a reduction in vet visits and therefore, reduction in number of doses of some products such as parasiticides. The other thing that we’re watching very carefully that we are starting to see, is also a reduction in overall consumption of protein. So as you limit tourism, and you limit travel and you limit people going out to eat, there’s a reduction in overall protein consumption. Some of that moves to the grocery sector and people buy it, but it tends to change when it does. So most of us, when we go out, we tend to buy the larger steak. In when we’re home, we eat the chicken or the burger. So the nature of what you’re buying sort of changes. And I know that I don’t make steaks the same size at home that I tend to find in restaurants, so the overall volume changes. So we are watching that as to how that progresses as it spreads to sort of Europe and the U.S. But for us in China we saw, in 2019, a significant outbreak called African Swine Fever. We were expecting a significant uptick in exports from the U.S. and Brazil and Europe into that market, great demand. I will say the frozen supplies have gotten very low in China. Some of that supply that we, the U.S. and Brazil and other people, ship get stuck at the ports with coronavirus. And then when it did, it was getting frozen since the overall consumption level in China has not scaled the same level. But remains to be seen — I mean at this point, this is all within our guidance range, but remains to be seen is if this lasts much longer and these consumption patterns of much less eating out at restaurants, much less tourism and travel, that could be a longer term but it’s a little too early for us to see. But from a demand perspective, that’s really where we see the risk.

Question – Kathleen Marie Miner: Are you seeing the decreased pet visits in this country also or other part of Europe…

Answer – Kristin C. Peck: No. I mean that would just be starting that — we have — we saw it in China, obviously. I mean a lot of them, they weren’t allowed out. I mean vets weren’t even allowed to open. So by definition, that happened. We haven’t seen that yet in the U.S. or Europe. But that’s certainly — having watched what happened in China, what we’re watching for right now as we understand what the potential impact will be. But again, it really depends on how long that is. Because a lot of those will be made up. So sometimes that’s more doses that you’re missing.

 

Agilent (3/3 – Citi Conference)

I mean, your guidance assumes a 1.5 to 3-week impact from coronavirus in China based on the fact that you got a factory up and running. The second factory is 70%, 75% up and running. It feels like things are not worse than what you — at least in China specifically.

Answer – Robert W. McMahon: Yes, that’s correct. Yes. I mean, things are tracking to kind of we expected. Now, I think we said this on the call that, at our earnings call, we expected February to be the brunt of it. And we’ve seen that. And — but we’re exiting February kind of where we expected it to be, not only from a factory perspective, but one of the other areas that we look at is service calls. And the service call rate at the end of this month was tracking pretty in line with where it was the end of February last year, which is actually very positive. Now how we’re actually doing the service is very different. So the investments that we’ve been making in WeChat over the last 2, 3, 4 years is really paying dividends because we’re actually doing service calls via WeChat as opposed to having people on site in certain factories and so forth.

 

Regeneron Pharmaceuticals (3/2 – Cowen Conference)

So where are we right now? With the new coronavirus outbreak, we have already immunized mice to develop fully human antibodies to the infection. We are now at the point where we are identifying lead candidates for treatment and prophylaxis treatment. It’s our intent to have the lead antibodies manufactured and ready for clinical trial use later this summer. While we’re not able to share more details with you at this time, know that this is a priority for Regeneron to address this important human health need.

 

Gilead Sciences (3/2 – Cowen Conference)

So remdesivir as a molecule, we’ve had at Gilead for a while. It was discovered and developed as an antiviral with a relatively broad antiviral activity in-vitro. It’s shown efficacy in-vitro against Ebola, which is a different class of virus, but also against SARS and MERS, which are both coronaviruses in-vitro. The homology of the polymerase that remdesivir inhibits is very high between SARS, MERS and this new coronavirus. So I think that’s probably one of the biggest drivers of why we are interested and others are interested in it.

More recently, we’ve gotten data from the Chinese CDC, where they’ve evaluated in-vitro efficacy and have demonstrated in-vitro efficacy of remdesivir against this particular isolate. We are awaiting data from our CDC here in the States to confirm that. There’s a slight difference between the 2 and that the Chinese CDC use vero cells or monkey cells and the U.S. CDC will use human cells. So we think that will be a little closer to what actual efficacy, at least a potency against the virus will be.

That’s in-vitro data. I think, really, it’s really important to emphasize there’s an investigational drug and we are in clinical trials right now, and those fall into several categories. We do have compassionate use work going on. You’ve seen the New England Journal article on that one patient. There have been other patients who’ve been treated with compassionate use. Those are all anecdotal.

There are 2 trials going on in China. They’re sponsored by and run by the investigator in China. We supply drug to them. There’s one in severe patients, one in more moderately ill patients and those studies are active and ongoing. And hopefully, we’ll see data from those in April, depending on enrollment.

And then the NIAID, we’ve been working with them to get another trial up and running. That study is now up and running in Nebraska and we’re looking to expand sites there. The NIAID will be doing that but we’re trying to support as best we can. And then, finally, we’ll be running sort of a simple trial that we’ve also been discussing with the FDA around making that trial available more broadly.

 

Johnson & Johnson (3/2 – Cowen Conference)

With respect to the vaccine, I think you’re — what Dr. Fauci had referenced in terms of 12 to 18 months is probably a very reasonable time line. If you just think about what has to happen with respect to, first, having some animal studies, making sure it’s then safe in humans and then the efficacy part, that seems to be as quickly as, I think, anything can be done.

With respect to our candidates for a vaccine, we are screening possible vectors. Where we have a differentiated capability, we believe, is around our scalability. So the ability to produce hundreds of thousands of vaccines is something that’s not uniquely possessed within the industry. And if you think about what we did on both the Ebola and HIV front in terms of some clinical development trials that we are now conducting, those are in the hundreds of thousands.

So if you remember an acquisition we did many years ago known as Crucell. They had a PER. C6 technology there that allows us to have this kind of manufacturing capacity. So whether it’s a vaccine that we potentially discover or some other vaccine that may be a candidate to contain the virus, I would imagine, we’re some part of the discussion. In fact, I believe, Alex and Paul are with the administration this afternoon with other health care CEOs and management to help figure out what is the best solution and best path forward.

In terms of business impact because I’m sure that’s on everybody’s mind as well, right now, I would say I don’t anticipate — and I’ll caveat my comments to be first quarter contained, right? Until we find out how long the duration of this is, the pervasiveness of the virus is, it would be hard to say we would certainly provide the best information we have available on our April call to recap the Q1 results.

I would say, though, from a supply perspective, I’m not overly concerned. I think if you look at where our supply chain exists, we’re pretty well covered. On the demand side, I could see some modest impact in Consumer, around Skin Care in terms of just people buying less. There’s less activity in that, but perhaps that’s offset by self-care. So think of MOTRIN or even LISTERINE potentially.

On the Pharmaceutical side, people still will take those drugs. You may see some lower demand from closed or limited hours for infusion centers or even pharmacies. But by and large, I think we’re pretty well covered there.

Medical Device, as other peers in our industry have indicated there, we are seeing a much reduced level of elective surgeries. And so we’ll probably track to the market there. Overall, though, I think if I look at the overall health of Johnson & Johnson’s business, I see this as a temporary blip that will largely be recovered.

 

Dentsply Sirona (3/2 – Q4 2019 Earnings Call)  

During this difficult period, our priority has been the safety and welfare of our associates. At the current time, we have not experienced a significant disruption to our global supply chain due to coronavirus. However, in many parts of China, dental clinics and hospitals remain closed for business. And in other parts of the world, we are beginning to see an impact.

Given the unique situation, today, we’re letting you know that China, Japan, Korea and Taiwan, represented approximately 10% of 2019 sales. While we hope the impact of the virus is controlled as soon as possible, it is difficult to estimate at this time when commercial activity, and more specifically, the dental market will return to normal levels.

We estimate that in the first quarter of 2020, we have an exposure of approximately $60 million to $70 million in sales stemming from coronavirus. Assuming activities get back to normal in April, we estimate a non-GAAP EPS impact of $0.10 to $0.12.

We acknowledge it is more difficult to forecast accurately in the current environment, and this explains the wider than usual EPS guidance range we are providing today.

With that said, these are the key elements of our guidance for fiscal ’20. We expect 3% to 4% internal revenue growth. However, accounting for the potential impact of coronavirus in the first quarter, we believe growth will likely be towards the bottom end of the range. We expect roughly a $30 million currency headwind for the year.

 

Exact Sciences (3/2 – Cowen Conference)

This year, on our fourth quarter call, we talked about the flu also having an impact on the business. Coronavirus, I think it’s still very early, so it’s something we’re watching closely. To the extent that it does have an impact on the business, again, I would think it would be temporary like the flu.

 

Edwards Life Sciences Corp (3/2 – Cowen Healthcare Conference)

Question – Joshua Thomas Jennings: Well, generally, your front-burner issue clearly is COVID-19. And just wanted to maybe review, I mean, China has been the hardest hit, just Edwards’ exposure to China to start with. And then maybe we can just ask a couple of more follow-up questions. I know it’s a fluid situation in all regions. But maybe we could just start with China and Edwards exposure and going on from there.

Answer – Scott B. Ullem: Sure. So I mean our biggest concern, of course, is the patients that we’re supporting and our employees in the region. And so we’re watching that carefully. In terms of production, we don’t have any real production directly in China. But you’re right, it’s a fluid situation. So we’re watching this unfold.

Question – Joshua Thomas Jennings: And just in terms of there has been some spread into other regions, we’re hearing about some cases in Europe and more and more diagnosis, some in the United States, very early, but any sense of impact outside of China and maybe not just to Edwards but just from a procedural standpoint, electroprocedures, per se? And maybe we can talk about the electiveness of TAVR in the (inaudible)?

Answer – Scott B. Ullem: Yes. So I think we’re probably best positioned to talk about TAVR specifically rather than other sectors within health care. But it’s something we’re watching carefully for the diseases that we treat, such as severe aortic stenosis. This is not an elective procedure. It’s a procedure that is time sensitive, and patients need to care as soon as they can get it. And so we’re working with our hospital partners, with our physician partners to do everything we can to support cases and watching carefully as this disease starts to make its way into other geographies.

 

Biogen (3/2 – Cowen Conference Healthcare)

Question – Philip M. Nadeau: One thing that we’ve all been focusing over the last week is COVID-19 and the potential disruptions to supply chains. Can you remind us of your exposure to Asia? And maybe just generally what the redundancies in your supply chain, should there be further disruptions in Asia or worldwide?

Answer – Michel Vounatsos: So we established — we have established a subsidiary in China last year. The exposure so far is really negligible, I will say, unfortunately. But we timed this increase for the company because I’m a strong supporter of China in terms of market and epidemiology, and it’s a great place to be. But versus the current crisis, supply chain is good. So far, so good.

 

Steris plc (3/2 – Raymond James Institutional Investors Conference)

Question – Lawrence Soren Keusch: No, we have about 10 minutes, so we can do some Q&A in the room. Mike, let me start off because, obviously, this will come up throughout the day, which is the situation with coronavirus, obviously, clearly remains dynamic. But maybe you can remind investors about the exposure for STERIS from both a revenue and supply chain perspective, I guess, focusing in on the Asia Pacific area. So that sort of question. And then have another one after that.

Answer – Michael J. Tokich: Yes, certainly. So for STERIS, our revenue base in — well, China, particularly, even in Asia Pacific is not really material. It’s not large for us. So we do not think that as of right now we would have any material impact from the coronavirus. Obviously, that’s on a top line standpoint. Supply chain is the only concern we would have. But for us, we have all the inventory we need to finish this fiscal year, so it would actually be into next fiscal year, depending on how long this issue lasts, we would more comment on that in May time frame. But for this fiscal year, I think, again, we would not — we do not expect to see a material impact through the rest of this month to finish our fiscal year.

Question – Lawrence Soren Keusch: Okay. And then I guess, just following up on that. So is it fair to say that China is around 5% of revenue or is it less?

Answer – Michael J. Tokich: Yes, it’s less, it’s probably low single digits, China itself. So what we do in China, we have a, I’ll call it cherry picking strategy. We use dealers or distributors. We do not have feet on the ground for our own sales force. And we are targeting the Tier 1 or private hospitals in China, who want to look more like the U.S. So very nascent for us from a top line standpoint.

Question – Lawrence Soren Keusch: Okay. And just to finish up on this topic. If the virus sees an increasing spread into Europe and the U.S. and elective surgical procedures are curtailed. I would assume that the hospital sterilization business could see some impact. Maybe AST has a little bit more insulated and less companies start to reduce manufacturing. Is that fair?

Question – Michael J. Tokich: Yes, I would say, I would agree with you. So I mean, if you look at the largest part of our business, it’s all about surgical procedures. So any time there is a slowdown in surgical procedures. Obviously, we would potentially be at risk on that point. I would say that the AST business probably is a little more insulated, as with life sciences. Obviously, if there’s vaccines or something of that nature for the virus and that could actually help us on the back end.

 

Novartis (2/28 – Annual Shareholders Meeting)

Question – Unidentified Shareholder: [Interpreted] Good morning, ladies and gentlemen. I’m [Volte Krov] from Bern. Chairman, I’d like to begin by thanking you because some things have improved since the years of Vasella. Mr. Vasella, back then, we just used to get a coffee and a croissant. We’ve been getting much better catering in recent years, so thank you very much.

I would like to know, though, whether you’re going to be signing up to the call for tender from the Swiss national research fund to develop a vaccine or treatment for coronavirus. That would be a very nice thing for the company to do.

Now I want to say something about the dividend. I think we’re only getting a 4% increase. It’s absolutely miserable. You could certainly have paid a higher dividend that this CHF 0.10 that we’re getting on top of last year is, frankly, laughable.

I also want to talk about the share price. Nestlé and Novartis used to have very close share prices. Nestlé has gone up to over CHF 100 now, whereas Novartis is jogging along behind. Why can’t you do better? You should start doing better, I believe, not just talking about doing better.

I want to hear what happened in the end with the case in Greece as well, please? Because there was a hefty scandal there, but it’s all gone rather quiet in recent times. So I’d like to know how that one turned out, please.

Answer – Joerg Reinhardt: [Interpreted] Yes. Thank you, Mr. [Krov]. Yes. Well, a little increase in the dividend. That’s better than we’ve had in some years. So we’ll see what we can do next year.

As to vaccines for coronavirus and others, our vaccines business was sold off to GSK a couple of years ago. So our vaccine experts, well, they moved to GSK at the same time, and I’m sure they’re very busy trying to develop a vaccination for coronavirus as we speak. So that would be for them. When you have exited a business of that type, it’s not very easy to just jump back into it. And I’m sure that all companies around the world who work in the field of vaccines are very busy trying to come up with a vaccine for coronavirus. They will be heavily involved. If you’re not a company working in the field of vaccines, then it’s not something you can just dream up overnight. We decided that vaccines were not a business for us, and I’m afraid, that, that remains the case regardless of coronavirus.

 

Mylan N.V. (2/27 – Q4 2019 Earnings Call)

I want to take a moment to address the very serious matter of the coronavirus. We’ve been in close contact with our colleagues around the world regarding recent developments and are following government and health organization recommendation. The health and safety of our teams and their families is our priority, and we’re supporting those on the ground where possible.

Our business exposure in China, specifically, is limited. However, given the global nature of our supply chain, operations and businesses, our results could potentially be impacted. The guidance we disclose today does not include any anticipated impact from coronavirus, however, we will continue monitoring the situation very closely from a business perspective.

 

Insulet Corp (2/27 – Leerink Global Healthcare Conference)

Question – Danielle Joy Antalffy: Yes, okay. That’s great. One other question, while we’re on this, what questions we’ve been getting since the earnings call, on COVID-19 and the impact there. And you guys did talk about this, but I think what folks are trying to get a handle around is, is there any risk to the guidance? Or do you feel like this is very much under control and reflected in the guidance from a supply perspective, you obviously don’t sell into China?

Answer – Wayde D. McMillan: Yes. So no impact to the guidance at this point. What we said on our earnings call on Tuesday was that we had sufficient inventory going into the quarter. We are lucky enough to be one of the people in China that has our employees ramping up at the plant. We are manufacturing at the plant. We’re shipping, and we also have our U.S. manufacturing with our first-line ramping up here in the U.S. So that’s providing us some redundancy already. It’s still early in that Line 1 and the yield coming off that line, but it is starting to contribute. So between our China manufacturing ramping up, our U.S. manufacturing starting to produce and the inventory we had, we feel confident at this time. As Shacey said on the call, our #1 concern is our employees there and our people traveling. And so we’re monitoring that very closely. We’re also monitoring our ramp-up over time. It is a day-to-day thing. Our team is very focused and working with our third-party manufacturer, literally daily. We have a very strong team here, experienced team working it. So that gives us the confidence that we’ll be able to continue to ramp in our third-party facility. We’ll continue to ramp in the U.S. and gives us the confidence that we’ll be able to manage through this. Having said that, I don’t think anybody really knows where this thing is going to go over time. And so we just have to continue to manage it literally day-to-day.

 

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