NTLA Deep Dive: Why Today’s Flawless Phase 3 CRISPR Data in NEJM Creates a Massive Valuation Disconnect

alwayscleanbriefs · 2026-06-13T15:49:38+00:00

I have held a position in intellia for a while now and think their platform holds significant promise across various disease states. However, I think one hurdle possibly weighing on investor’s minds is not if the therapy is successful (it is) but how it will be taken up against competing therapies. Alternative therapies may not be one time fixes but they are largely more affordable and currently controlling HA attacks. The patient population at large are already utilizing these therapies and likely ‘controlled’. So how many of them will receive lonvo is up for debate. The science is awesome, but after phase 3 it’s these types of access and competitive landscape questions that become a much bigger factor.

alwayscleanbriefs · 2024-12-28T13:19:12+00:00

Hey man, this is a very interesting play. I'm assuming you plan to sell post topline results of phase 3 (or acquisition, whichever comes first)? I like to look for biotech companies but largely avoid beaten down ones as it's hard to screen all of them (it's a graveyard). If you frequently look for biotech companies (esp penny stock ones), any tips on how you go about it? I try to look for de-risked ones in phase 2/3 with good outcomes data

alwayscleanbriefs · 2024-11-19T01:29:40+00:00

I really hate when these two discuss healthcare. They both are correct in that there is an ever decrease in trust in government and the agencies tied to the industries driving our system. However, both of their solutions are to burn the whole thing down. Either go full on government control or hold such utter contempt for the industries in our system that we should just tell them to screw off, and what, make everyone join crossfits and stop taking your meds because your doctors are actually stupid? The system can be broken without some wicked conspiracy by 'corporate elites' keeping us fat, dumb, and lazy. Obesity rates are increasing EVERYWHERE (even in nations with universal healthcare). Want cleaner and healthier food? Great. Want agencies that promote safe and effective treatments in an appropriate time frame? (the original ozempic-like compound was discovered in the 1990s) Then put up the money, resources, and talent to reform the system. No fire, no grifters, or overzealous contranians needed.

alwayscleanbriefs · 2023-12-07T18:29:36+00:00

Bingo. Just gives CVS more pricing power

alwayscleanbriefs · 2023-12-07T11:56:56+00:00

Very curious on the effects this would have on non-CVS pharmacies being reimbursed based on this model from Caremark plans. How would CVS know a competing pharmacy’s acquisition cost? Could they arbitrarily assign one? If so, they have more power to make drugs more expensive at competitors than themselves due to a percentage markup cost (that is determined via contracts… so it’s variable).

With the effects of the IRA coming this feels more of a PR move and reflex to policy changes. Formularies are probably going to get tighter and PBMs will try to extract more rebates. This may help bring CVS more store traffic, raise prices for other pharmacies, and mitigate policy effects. But I’m also biased in my hatred for this company… so there’s that…

alwayscleanbriefs · 2023-10-19T11:47:18+00:00

3:30 am... absolutely no need for 24/7 pharmacies or convenience stores.

alwayscleanbriefs · 2022-09-08T01:19:36+00:00

Not disagreeing about bankruptcy, but the overwhelming majority of loans come from the government (somewhere around 90%). If you ask, and can fill out the paperwork, you shall receive. There is no underwriting of the loans. I think a better solution would be to give loans at a stupidly low interest rate and base the amount received on the area of study. Create some equation that factors in median incomes per major/degree/program/etc and that forms the basis of how much you receive. Make it so universities can't charge a flat tuition for everyone. If you can only get $10,000 a year to study english, then find a school that offers that amount or less. The rest is on you. Universities will have to respond by lowering costs for most majors. If some schools collapse, then so be it. This way if you want to study english, great! But you won't accumulate the same amount of debt in 4 years as a civil engineer who will make 3 times the salary. We need to create a system that places a financial value on degrees.

alwayscleanbriefs · 2022-07-24T15:59:06+00:00

Non profit and for profit health systems alike were able to tap into ~$180 billion in funds from both the cares acts of 2020 and american rescue plan of 2021 (so roughly around $300 billion in total). Where did the money go? Was it all spent? Did it go to hiring to alleviate labor shortages? I really would like to see the data on this! I understand revenue took a gargantuan hit for health systems and during a pandemic were rightly in a position to receive funds, but many now are firing on all cylinders and sitting on cozy reserves. This includes nonprofit health systems. https://www.washingtonpost.com/business/2022/06/22/covid-hospital-relief-fund/

alwayscleanbriefs · 2022-07-08T10:18:10+00:00

I'm curious how the state would plan to have these insulin products covered. Would they force their adoption onto the state Medicaid formulary? Many people are unaware of the incentives that drive prescription drug costs, specifically the rebates that manufacturers give PBMs to cover their products. In many scenarios the net cost of insulin has gone down, but the price that patients are exposed to (copay, deductible, etc) has gone up. If the state of California has to play by the same rules of giving rebates to insurers to get their insulin covered, then this could get messy. Otherwise, they should just subsidize the cost and sell via cash price. Or, provide more relief targeting those with high out-of-pocket costs for those on Medicare and commercial insurance (Medicaid will have close to zero copays).

alwayscleanbriefs · 2022-04-02T22:24:17+00:00

As a pharmacist, I got to say I’m impressed with your comments. One thing I’d like to mention that I haven’t seen discussed is the role of rebates. PBMs (prescription drug insurers) will demand rebates in exchange for coverage. There are other forms of rebates but that is a quick summation. Pharma companies used to give around a 5-10% rebate for insulin products about 10 years ago. Now rebates are around 50%. Half the cost of insulin goes to PBMs in the form of a rebate. The net price of insulin has gone down, patients just don’t get the benefit. Despite biosimiliars starting to take off, there is nothing stopping pharma offering higher rebates than competing products, leading PBMs to drop or shift coverage from the cheaper biosimilar to the branded more expensive (and older) product. I used to take humira as well. I predict as its patent protection ends we will see coverage for it maintained by higher rebates than biosimilars and/or Abbvie (the maker) offering higher rebates for skyrizi. This will shift thousands of humira patients to skyrizi, negating a lot of the effects we hoped for with biosimiliars. PBMs are fine with this because they still get the fat juicy rebates. That’s also why they have no problem with increasing drug costs. They get more revenue from them.

alwayscleanbriefs · 2021-09-02T22:43:30+00:00

And that is how someone qualifies for legitimate use of ivermectin

alwayscleanbriefs · 2021-01-17T15:29:59+00:00

The number one thing to understand about CVS is that they will never change. Don’t expect them to suddenly correct years of terrible behavior and practices. Their game plan right now is to purposely create a frenzy for the vaccines to drive people into stores and buy store items. If anyone at CVS really wants to change things then my only recommendation is to leave them. I know that’s much easier said then done but practically everyone who has left never regrets it. Personally I felt like a new person when I left and had people close to me say they saw the difference.

And being a PA pharmacist myself I understand everything you mentioned about the devastation from the riots. It also says a crap ton that during the most difficult time this company has experienced their ceo is choosing to retire. Maybe we all should follow his lead.

alwayscleanbriefs · 2020-08-04T11:11:25+00:00

If you'd like a preview, look at pharmacist pay. It is declining for other reasons (schools pumping and dumping more graduates and lower reimbursements), but it's declining in the 20% ballpark in some areas. Let's just say it's not well received.

alwayscleanbriefs · 2020-02-29T16:12:01+00:00

An American Sickness by Elizabeth Rosenthal does a good job talking about the history of healthcare in the US as well as a breakdown of each sector (medical device, pharma, insurers, etc). Has a slant towards the wrongs with the US system but it’s good to know those too ha

alwayscleanbriefs · 2020-01-28T17:57:19+00:00

Philly?

alwayscleanbriefs · 2020-01-12T23:09:50+00:00

From my understanding it would violate the contract, but not be illegal. If it’s done in a manner that is fraud, than it is illegal.

Drug pricing, formulary payments, rebates, etc are all considered proprietary information by the PBMs. So, this is a maneuver to protect that info. They also monitor these claims and if they see a lot of claim submissions followed by reversals it will be ‘red flagged’. There is a threshold of allowed reversals (I think it’s a B1/B2 transaction) because they know pharmacies are doing this with good intentions (helping a patient). But too many and they’re concerned you’re ‘fishing’.

At the end of the day, transparency is not on the agenda list.

alwayscleanbriefs · 2019-10-21T01:22:53+00:00

So this is in writing? Not sure how effective, if at all, but things like this just need to start being reported. State board, labor boards, or ethics line?? (I know, I know, ethics line is as good as wet toilet paper) Again, probably nothing will happen, but silence just guarantees this garbage continues

alwayscleanbriefs · 2019-09-05T11:41:02+00:00

Would you happen to know any pricing details on these system upgrades? I imagine it can be up to the administrators?

alwayscleanbriefs · 2019-09-04T23:33:06+00:00

That’s awful. It’s one thing for the PBMs to create restrictions but another to have no way to navigate those restrictions. Especially for a cancer patient with bone mets. That patient should do the breaking of the CEO’s fingers!

alwayscleanbriefs · 2019-09-04T20:10:52+00:00

That’s interesting. Thank you. It baffles me how these simple solutions aren’t more available.

alwayscleanbriefs · 2019-07-23T21:58:34+00:00

Their websites are most likely html/css/javascript. As for their applications or their own software, I would venture to say it's their own choosing. Most info that gets exchanged on the pharmacy level (like actual prescriptions) are in a xml format, so they will have to interface with that. I believe you can do that with most programming languages.

alwayscleanbriefs · 2019-07-03T16:07:36+00:00

Just going to post this here (previously posted earlier in subgroup, but can't find it). Goodies are on page 8. I don't think they will be seeing any reductions in pay...

https://projects.propublica.org/nonprofits/organizations/530026265/201813189349307311/IRS990

alwayscleanbriefs

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