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april@madhedgefundtrader.com

Triple - Locked And Loaded

Biotech Letter

Back in 1989, when I was setting up one of the first international hedge funds, I learned a timeless lesson about pharmaceutical stocks: the market doesn't care what you think it should care about—it cares about whatever it wants to care about.

That was on full display last week, as I watched Amgen (AMGN) dance its post-earnings tango and rally despite the FDA putting a mysterious hold on its obesity drug trials.

The stock’s move was exactly what its technical patterns suggested.

After managing hedge fund money for decades, I’ve seen literally millions of chart setups, and AMGN’s current formation is one of those rare “textbook” moments that make veteran traders sit up a little straighter in their ergonomic chairs.

The numbers paint a fascinating picture. Amgen isn’t just any biotech; it’s one of the dwindling few in the Dow 30 that still yield north of 3%. In this market, that’s about as rare as finding a bargain at Sotheby’s.

Better yet, it carries a dividend safety rating of A—something I’ve come to value above all else after living through multiple market crashes.

In my experience, dividend safety is the bedrock on which everything else is built, so seeing that in a company is like stumbling upon a bomb shelter with a view.

Digging deeper, the company just delivered a revenue beat that would make any analyst grin, but the real hook for me is the pattern of earnings revisions.

They’re trending up more than down, fueling a kind of momentum that reminds me of the early days of Genentech’s meteoric rise back in the 1980s.

Of course, there’s an elephant in the room: valuation.

With a D- grade in that department, Amgen’s price tag is about as stretched as my old climbing rope from Mount Everest. But modern markets aren’t your grandfather’s markets anymore.

The days of pure buy-and-hold being a guaranteed winning strategy have gone the way of paper trading tickets, replaced by algorithms and new trading paradigms.

This is why I like to employ what I call the "Triple-Lock Position" strategy.

Essentially, you buy the stock, buy a put for protection, and sell a call to offset that cost - three distinct moves that work together to lock in your risk parameters.

With Amgen hovering around $300, one round lot sets you back roughly $30,000. That price tag is a good reminder that position sizing matters more than ever.

Meanwhile, Amgen’s profitability metrics remain consistently top-tier.

From my hedge fund experience, steady cash flow and consistent profits often trump the promise of explosive growth, especially when storm clouds gather.

In volatile markets, companies that can reliably generate cash tend to outlast the flashier high-flyers.

Then there’s the technical angle. After analyzing enough charts to wallpaper the old Swiss Bank Corp building, I can say these trend lines have been as reliable as a Swiss watch.

Yes, we see the occasional short-term break, but it’s akin to a compass briefly pointing south before swinging back to true north.

For those who track this stuff closely, AMGN appears to be offering one of those rare situations where technical strength aligns with fundamental quality.

So what’s the play? I see Amgen as a “buy the dip” opportunity, but I suggest doing it with a twist. Instead of simply loading up on shares the old-fashioned way, consider collaring your position or using call options to define your risk.

Markets these days reward flexibility, and adapting your strategy to the current environment is crucial—something I learned during the Asian financial crisis, when clinging to outdated rules was a surefire path to disappointment.

All of this brings us back to that FDA hold on AMG 513. The market’s collective shrug reminds me of an old trading floor saying: “The market will decide what to worry about, not us.”

In biotech, as in most sectors, the reaction to news often reveals more than the news itself. Watching how investors brush off certain announcements can be more informative than pouring over the finer details.

Keep a close eye on those trend lines, because they’ve served as a pretty good compass so far. AMGN is showing the kind of setup where technical signals and strong fundamentals converge, and that rarely goes unnoticed for long.

Just remember, in the modern market, it’s not only about what you buy; it’s about how you buy it. The once-reliable buy-and-hold mindset is no more current than my old Financial Times columns from the 1970s.

Now, if you’ll excuse me, I need to check on my option positions. The market waits for no one—not even old hedge fund traders with stories to tell.

 

https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png 0 0 april@madhedgefundtrader.com https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png april@madhedgefundtrader.com2025-02-13 12:00:292025-02-13 11:54:40Triple - Locked And Loaded
april@madhedgefundtrader.com

February 11, 2025

Biotech Letter

Mad Hedge Biotech and Healthcare Letter
February 11, 2025
Fiat Lux

 

Featured Trade:

(SPLICING THROUGH SKEPTICISM)

(CSRP), (VRTX), (AMZN), (TSLA)

https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png 0 0 april@madhedgefundtrader.com https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png april@madhedgefundtrader.com2025-02-11 12:02:052025-02-11 12:25:37February 11, 2025
april@madhedgefundtrader.com

Splicing Through Skepticism

Biotech Letter

When I pioneered fracking technology in Texas years ago, skeptics said we were crazy. Today's skeptics are saying the same thing about CRISPR Therapeutics (CRSP), and they're just as wrong.

Here's a company sitting on a $1.9 billion cash fortress, burning through a mere $100 million per quarter – giving them enough runway to circle the Earth 19 times – and yet the stock has drifted down to $40, shedding 15% since my last analysis when it was perched at $48.

Talk about the market missing the forest for the trees.

Remember when everyone thought Amazon (AMZN) was just a bookstore? Well, CRISPR Therapeutics isn't just another biotech company – it's the Tesla (TSLA) of gene editing, with Vertex Pharmaceuticals (VRTX) riding shotgun.

And just like Tesla wasn't just about making electric cars, CRISPR isn't just about Casgevy, their FDA-approved treatment for Sickle Cell Disease (SCD) and Transfusion-Dependent Beta Thalassemia (TDT).

Speaking of Casgevy, let's tackle the elephant in the room. Yes, patient enrollment has been slower than a government committee deciding on lunch options. They've collected cells from over 50 patients by year-end, up from 20 in mid-October.

Not exactly setting speed records, but here's what the market is missing: the Centers for Medicare and Medicaid Services just inked a deal with Vertex/CRISPR that could be a game-changer.

Why? Because 50-60% of SCD patients are on Medicaid.

But wait, there's more happening behind the scenes. The company has been quietly building an empire across 5 clinical programs and 10 preclinical programs.

Let's break down what's cooking in their kitchen.

The Casgevy rollout has expanded from 35 treatment centers in October to over 50 by year-end.

Eight jurisdictions have given them the green light, including Saudi Arabia – a market where SCD is about as common as sand.

The UK just signed on for reimbursement, first for TDT in August 2024, and now for SCD.

Their CAR-T program isn't just targeting blood cancers anymore. They've expanded into autoimmune diseases like Systemic sclerosis (SSc) and Idiopathic inflammatory myopathy (IIM).

We're talking about potential treatments for 2.5 million SSc patients globally (125,000 in the US) and 1 million IIM patients (50,000 in the US).

That's not just a market – it's an ocean.

They're even taking shots at liver cancer and cardiovascular diseases. Their latest trial for Heterozygous familial hypercholesterolemia could be a lifeline for patients with this genetic cholesterol disorder.

And speaking of cash runways, their $1.9 billion war chest means they can keep this scientific symphony playing for 19 quarters without passing around the collection plate.

In biotech terms, that's like having enough food to last through three winters.

Institutions are noticing, too. Cathie Wood just backed up the truck, dropping $10 million more into CRISPR, making it her 9th largest holding at $350 million. Her ARK funds now own over 9% of the company.

When smart money moves like this, I pay attention.

Here's the kicker: While most analysts raise their ratings as speculative stocks climb (a strategy that makes as much sense as buying umbrella futures during a drought), I'm doing the opposite.

After all, the fundamentals are stronger than ever, but the price is lower.

Looking ahead to 2025, we've got more potential catalysts than a chemistry textbook. Phase 1/2 trial data for CTX 112 is coming in Q2/Q3, CTX 131 in Q3/Q4, and updates on their Type 1 Diabetes program in the second half of the year.

Remember, this is the same company that has Vertex Pharmaceuticals – the biotech equivalent of having Warren Buffett as your investment advisor – as a partner.

They're not just getting financial support; they're getting a masterclass in how to commercialize breakthrough treatments.

The verdict? Load up on shares while the market gives us this gift wrapped in fear and uncertainty.

Twenty years ago, they called us crazy for thinking we could extract oil from solid rock. Today, they're just as skeptical about editing genes.

History has a funny way of repeating itself.

 

https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png 0 0 april@madhedgefundtrader.com https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png april@madhedgefundtrader.com2025-02-11 12:00:562025-02-11 12:25:24Splicing Through Skepticism
april@madhedgefundtrader.com

February 6, 2025

Biotech Letter

Mad Hedge Biotech and Healthcare Letter
February 6, 2025
Fiat Lux

 

Featured Trade:

(YOU MIGHT NEED ASPIRIN FOR THIS ONE)

(PFE)

https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png 0 0 april@madhedgefundtrader.com https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png april@madhedgefundtrader.com2025-02-06 12:02:132025-02-06 11:49:26February 6, 2025
april@madhedgefundtrader.com

You Might Need Aspirin For This One

Biotech Letter

Last Tuesday, while filing away some tax documents, I found myself staring at an old prescription bottle from 2020. The Pfizer (PFE) logo caught my eye, and ironically, that same morning they dropped their Q4 earnings report.

The timing felt symbolic – much like that old bottle, Pfizer's COVID glory days are now just a memory on their financial statements.

The numbers looked good on the surface. EPS of $0.63 beat expectations by $0.17, and revenue came in at a healthy $17.8B, crushing estimates by $540M.

But in the pharmaceutical world, today's blockbuster is tomorrow's generic, and Wall Street knows it. After all, the market's reaction was about as enthusiastic as a patient reading medication side effects.

Let me paint you a picture of what we're dealing with here. Imagine going from making $100.3B in 2022 (those glory days of COVID) to $58.5B in 2023. That's not a haircut – that's a full-blown scalping.

Sure, they bounced back to $63.6B in 2024, but their 2025 guidance of $61.0B to $64.0B suggests they're treading water at best.

Now, here's where it gets interesting, and not in a good way. Remember how I always tell you to look under the hood? Well, Pfizer's engine is about to lose some major parts.

By 2030, they're saying goodbye to patents on Eliquis (a $6.7B revenue generator) and Ibrance (worth $4.8B). That's like losing your two best-performing stocks in your portfolio – it hurts.

Speaking of pain, I had lunch last week with a pharmaceutical industry veteran who couldn't stop talking about the "LOE wave" – that's "loss of exclusivity" in pharma-speak. CEO Albert Bourla puts it at about $17-18 billion in lost revenue over the next 3-4 years.

To put that in perspective, that's like losing the annual GDP of Mongolia. The company's solution? They're promising to deliver $20 billion in new revenues by 2030 through their pipeline of new drugs.

One bright spot worth watching is their oncology division, which grew an impressive 27.4% year-over-year in 2024.

Their promising candidate Atirmociclib, a CDK4i inhibitor for metastatic breast cancer, enters Phase 3 studies in the first half of 2025.

With a 44% historical success rate for these types of studies, it's targeting a massive market – the global breast cancer therapeutics market hit $34.63 billion in 2024 and is expected to reach $89.01 billion by 2034, growing at a healthy 9.90% annually.

That's the kind of growth potential that gets my attention.

The stock currently sports a 6.7% dividend yield, which might look tempting – like that last piece of chocolate cake in the refrigerator at midnight.

But here's the rub: pharmaceutical companies are like Silicon Valley startups with lab coats. They constantly need to innovate just to stay alive. It's not enough to have one hit wonder – you need a whole playlist of blockbusters.

Trading at 8.91x forward earnings with a PEG ratio of 0.20 and 2.5x price/sales, Pfizer does look cheap. But as I always say, sometimes things are cheap for a reason.

Want a shocking comparison? While attending the J.P. Morgan Healthcare Conference, I noticed that analysts are projecting Pfizer's 2029 revenues to be over $5 billion lower than 2024. That's not exactly the inspiring growth story I was hoping to hear.

For those of you hunting for yield (and I know many of you are), let me give you a reality check. That juicy 6.7% dividend looks appetizing until you realize it comes from a company that needs to spend billions just to replace what it's about to lose.

While I love a good yield as much as the next investor, watching a pharmaceutical company's patents march toward expiration is about as comforting as sitting in a dentist's waiting room.

Sometimes the best high-yield investment is the one you don't make – at least until the business fundamentals match the dividend's promise.

Want my advice? Keep an eye on their oncology developments, but keep your powder dry. There's a difference between buying a great company and buying a great stock at the right time.

Right now, Pfizer needs to prove it can fill an $18 billion revenue gap before I'm ready to write them a prescription for my portfolio.

 

https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png 0 0 april@madhedgefundtrader.com https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png april@madhedgefundtrader.com2025-02-06 12:00:372025-02-06 11:49:02You Might Need Aspirin For This One
april@madhedgefundtrader.com

February 4, 2025

Biotech Letter

Mad Hedge Biotech and Healthcare Letter
February 4, 2025
Fiat Lux

 

Featured Trade:

(TOO RICH TO FAIL, TOO EXPENSIVE TO SUCCEED)

(MRNA), (TSLA), (NVS), (SNY), (JNJ), (BNTX), (RHHBY), (REPL), (CRSP), (ORCL)

https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png 0 0 april@madhedgefundtrader.com https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png april@madhedgefundtrader.com2025-02-04 12:02:112025-02-04 12:07:23February 4, 2025
april@madhedgefundtrader.com

Too Rich To Fail, Too Expensive To Succeed

Biotech Letter

Last weekend, while organizing my home office, I stumbled across an old COVID vaccination card. Remember those? It got me thinking about Moderna (MRNA), the biotech darling that went from relatively unknown to household name faster than you can say "messenger RNA."

Now, in early 2025, this once up-and-coming company is already facing what my grandmother would call "champagne problems" - too much cash to be broke, but burning through it faster than a Tesla (TSLA) on Ludicrous mode.

First, let's talk about this biotech's cash burn. In just nine months of 2024, Moderna torched through over $4 billion - that's the same amount they burned in all of 2023, suggesting their cash cremation rate is actually accelerating.

This acceleration in spending wouldn't be as worrying if they had endless reserves, but their current position shows $7 billion in cash and $2 billion in non-current investments.

The math isn't complex: at this burn rate, their runway is shorter than many investors realize.

The recent Health and Human Services (HHS) grant of $176 million in July 2024 for bird flu research barely registers on their financial statements.

While we've seen about 70 bird flu cases in the U.S. with one fatality in an elderly patient with underlying conditions, this isn't going to be another COVID-style revenue stream.

I've analyzed enough pharmaceutical companies to know that betting on another pandemic windfall is like expecting lightning to strike twice in the same spot.

What really interests me is Moderna's position in the competitive landscape. I spent last week analyzing patent data and geographic reach metrics across the industry.

First, you've got the old-guard pharma giants like Novartis (NVS), Sanofi (SNY), and Johnson & Johnson (JNJ), who have been at this game since before mRNA was a gleam in a scientist's eye.

Then, there are companies like BioNTech (BNTX) and Roche (RHHBY) with significantly higher geographic reach, while Replimune Group (REPL) and CRISPR Therapeutics (CRSP) demonstrate superior application diversity.

In comparison, Moderna's position in this landscape shows relatively low scores on both metrics - not exactly what you want to see from a company burning cash at this rate.

Stéphane Bancel, Moderna's CEO, recently outlined their pipeline: 2 approved medicines, 7 Phase 3 trials, and 45 candidates in development. They're also targeting $1.1 billion in annual R&D cost reductions by 2027.

But here's what keeps bothering me: their SG&A expenses have ballooned to nearly 10 times their pre-COVID levels, yet management is focusing on R&D cuts instead of addressing this administrative bloat.

The insider trading patterns since early 2024 haven't exactly inspired confidence either.

When I see heavy selling from insiders while a company is promising future breakthroughs, I can't help but remember all the biotech stories I've covered where the promise didn't match the reality.

Speaking of promises, Oracle's (ORCL) Larry Ellison recently made headlines talking about 48-hour personalized cancer vaccines using AI and robots.

While the technology sounds promising, I'm more interested in the practical path to profitability. Moderna isn't alone in this race, and their well-capitalized competitors have the luxury of funding similar development programs while maintaining positive cash flow.

Given Moderna's cash burn trajectory, their next three quarters will be telling.

I'll be watching that $4 billion nine-month burn rate closely, along with their progress on cost reductions - particularly those inflated SG&A expenses that management seems reluctant to address.

I'm keeping my old vaccination card as a reminder of Moderna's impressive COVID-19 achievement, but I'm not ready to bet on lightning striking twice.

Sometimes the hardest part of investing is knowing when to appreciate history without banking on its repeat performance.

 

https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png 0 0 april@madhedgefundtrader.com https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png april@madhedgefundtrader.com2025-02-04 12:00:322025-02-04 12:06:04Too Rich To Fail, Too Expensive To Succeed
april@madhedgefundtrader.com

January 30, 2025

Biotech Letter

Mad Hedge Biotech and Healthcare Letter
January 30, 2025
Fiat Lux

 

Featured Trade:

(A CRITICAL PAIN POINT)

(VRTX), (AMZN)

https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png 0 0 april@madhedgefundtrader.com https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png april@madhedgefundtrader.com2025-01-30 12:02:362025-01-30 12:18:39January 30, 2025
april@madhedgefundtrader.com

A Critical Pain Point

Biotech Letter

Last week, while having dinner with an old friend who's an emergency room physician in San Francisco, I heard a story that stopped me cold. She had just lost another patient to an opioid overdose - the fourth one that month.

"We desperately need alternatives," she said, pushing away her plate. "Something that works without killing people."

She's not wrong. More than 80,000 Americans died from opioid overdoses in 2022 alone - that's about 75% of all drug overdose deaths in the country.

To put that in perspective, that's more than double the number of people who die in car accidents each year. In New York alone, opioid-related deaths have quadrupled between 2010 and 2020.

You can see where this is going. There's a massive market opportunity here for any company that can crack the code of non-addictive pain management.

We're talking about a potential market worth tens of billions of dollars. The holy grail? A drug that works as well as opioids without the devastating addiction potential.

Enter Vertex Pharmaceuticals (VRTX) and their sodium channel inhibitor VX-548, now known as suzetrigine. The company has been quietly plugging away at this problem, and I've been watching them like a hawk.

For those who've been following my previous coverage, you'll remember I wrote about their interesting (though modest) results in post-surgical patients a few months ago.

And here's where it gets fascinating. Vertex has been running multiple trials because - as any doctor will tell you - pain isn't just pain.

It comes in more flavors than Ben & Jerry's ice cream: acute, chronic, neuropathic, cancer-related, post-surgical, and don't even get me started on phantom limb pain.

Just before the holiday break, they dropped their latest results for suzetrigine in sciatica patients.

Now, I have to tell you something that might sting a bit. The drug worked - but so did the placebo. Both groups saw their pain decrease by statistically similar amounts.

Vertex argues the placebo response was unusually high and that a larger Phase III trial should smooth things out.

Maybe they're right - but I've seen enough clinical trials to know that placebo effects in pain studies can be trickier than a Wall Street hedge fund manager.

The FDA is expected to make a decision by the end of this month on suzetrigine for moderate-to-severe acute pain.

Despite the recent speed bump in the sciatica trial, I'm still keeping my eye on the bigger picture here. Vertex isn't a one-trick pony.

Their cystic fibrosis (CF) portfolio is absolutely crushing it. They just got FDA approval for Alyftrek ahead of schedule.

They've expanded Trikafta's approval down to patients as young as two years old, which is huge for their market potential. Plus, they’ve been aggressively pushing into international markets over the past months.

Now, let's talk numbers. Suzetrigine revenue is projected to hit $5 billion by 2035. That's not chump change, even if we hit some bumps along the way.

Trading at a P/S multiple of almost 10, Vertex isn't cheap - but then again, neither was Amazon (AMZN) in 1997.

Still, this biotech’s pipeline goes beyond pain management. We're looking at treatments for diabetic peripheral neuropathy, IgA nephropathy, type 1 diabetes, and even gene editing therapy.

So, here's the bottom line: Yes, the market got spooked by the Phase II data. Yes, there are risks. But remember - the FDA is under enormous pressure to approve non-opioid painkillers.

With 80,000 Americans dying yearly from opioid overdoses, they need solutions more than my trader friends need their morning coffee.

I'll keep watching this one closely. The pain management market is like a sleeping giant, and despite the recent hiccup, Vertex might just have the alarm clock.

or long-term investors, this could be one of those "I wish I bought it back then" moments.

Watch this space. The opioid crisis isn't going anywhere, but neither is Vertex's determination to solve it.

Sometimes the biggest opportunities come disguised as disappointments.

 

 

https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png 0 0 april@madhedgefundtrader.com https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png april@madhedgefundtrader.com2025-01-30 12:00:372025-01-30 12:18:19A Critical Pain Point
april@madhedgefundtrader.com

January 28, 2025

Biotech Letter

Mad Hedge Biotech and Healthcare Letter
January 28, 2025
Fiat Lux

 

Featured Trade:

(READY, RESET, GO)

(JNJ), (AAPL), (PFE), (ABBV), (RHHBY), (AZN),  (SNY), (NVS)

https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png 0 0 april@madhedgefundtrader.com https://madhedgefundtrader.com/wp-content/uploads/2019/05/cropped-mad-hedge-logo-transparent-192x192_f9578834168ba24df3eb53916a12c882.png april@madhedgefundtrader.com2025-01-28 12:02:492025-01-28 13:14:05January 28, 2025
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