Mad Hedge Biotech and Healthcare Letter
June 10, 2025
Fiat Lux
Featured Trade:
(THIS BIOTECH'S OBITUARY WAS PREMATURE)
(AMGN)
Mad Hedge Biotech and Healthcare Letter
June 10, 2025
Fiat Lux
Featured Trade:
(THIS BIOTECH'S OBITUARY WAS PREMATURE)
(AMGN)
Last Tuesday, while stuck in airport security behind a family debating whether insulin syringes count as "liquids," I had an epiphany about Wall Street's chronic inability to see past quarterly earnings reports.
Here was life-saving biotechnology reduced to a TSA checkbox, while across the terminal, CNBC was breathlessly explaining why Amgen's (AMGN) "patent cliff" makes it uninvestable. Sometimes the best opportunities hide in plain sight, disguised as disasters.
That absurd little scene reminded me of another moment burned into my biotech brain: Tokyo, 1970s, a smoky coffee shop. I once watched a businessman inject insulin with the calm precision of someone adjusting their tie.
It wasn’t dramatic. It was routine. And that’s what made it profound.
That image — cutting-edge science seamlessly woven into daily life — stayed with me. It’s also why Amgen, trading around $289, has me as intrigued today as I was back when calculators were a luxury.
Fast-forward to now: Wall Street is acting like Amgen is headed for biotech hospice care. Nearly 30% of its revenue base is tiptoeing toward patent expirations.
Prolia and Xgeva lost exclusivity in February, and biosimilar vultures are already circling. Enbrel, once a $3.3 billion cash cow, just took a 47% haircut on net pricing, dragging sales down 10% year-over-year.
The numbers look brutal…on paper. But investing based on spreadsheets alone is like judging a Michelin meal by the grocery receipt.
Here’s what the Street is missing: Amgen isn’t waiting for a mercy kill. It’s executing what might be biotech’s most impressive strategic pivot since Genentech discovered you could print money with recombinant DNA.
This is where MariTide comes in. Amgen’s obesity moonshot has been generating buzz since its trials started, and it’s starting to prove that it isn’t just another GLP-1 bandwagon play.
MariTide combines GLP-1 agonism with GIP antagonism into a once-monthly shot. This is a dramatic upgrade from Novo Nordisk’s (NVO) blockbuster, Ozempic, which requires weekly injections.
Think of it as rent once a year instead of weekly: same effect, way less hassle. Analysts are quietly penciling in $5 billion in peak sales.
Then there's olpasiran, which is a small interfering RNA therapy targeting lipoprotein(a) — a heart disease culprit with no current treatments. One in five people carry this risk, and olpasiran showed significant efficacy in the New England Journal of Medicine. This could be a multibillion-dollar market, rivaling the $9.3 billion PCSK9 inhibitor space.
And the delicious irony? Amgen’s discounted cash flow suggests the market expects the company to shrink. Negative 0.4% growth is priced in. But even 2.5% annual growth could yield a 27% upside.
Now, its first quarter results tell a different story. Revenue surged 9% to $8.1 billion. Operating margins improved despite brutal pricing pressure. Management projects 2025 revenue of up to $35.7 billion.
That doesn’t sound like a company preparing for its own funeral.
Smart money agrees. Amgen’s $27.8 billion Horizon acquisition brought Tepezza, a $1.9 billion play for Thyroid Eye Disease, into the fold.
Meanwhile, biosimilar Wezlana, aka the first Stelara lookalike with FDA approval, generated $150 million in its first quarter. These aren’t Hail Marys. They’re calculated, long-term bets.
What makes Amgen irresistible is the combo platter: steady cash flow (a healthy 33.3% free cash margin), ongoing shareholder returns, and moonshot optionality in MariTide and olpasiran.
It's the kind of setup that rewards patience, especially when the market is too distracted to notice the obvious.
It brings to mind something my old biochemistry professors used to say: the most elegant solutions often masquerade as problems until their brilliance clicks into place.
Amgen’s strategy, replacing aging blockbusters with next-gen therapies addressing massive unmet needs, is exactly that kind of misjudged genius. I suggest you buy the dip.
Mad Hedge Biotech and Healthcare Letter
May 1, 2025
Fiat Lux
Featured Trade:
(TELEHEALTH'S NEW WEIGHT CLASS)
(HIMS), (NVO)
Mad Hedge Biotech and Healthcare Letter
April 29, 2025
Fiat Lux
Featured Trade:
(BIOTECH’S AWKWARD MIDDLE CHILD)
(GILD), (VRTX), (AMGN), (BMY)
Well, folks, I've been trading biotech stocks since before most of today's analysts had their first internships.
After countless dinners with pharma execs and more investor conferences than I care to remember, there's one thing I've learned about this sector – these stocks are a lot like the experimental drugs themselves: sometimes miraculous, sometimes disappointing, and always requiring patience.
That brings us to Gilead Sciences (GILD), which has recently pulled off the financial equivalent of finding a $100 bill in an old jacket: a 90% gain since May 2024.
If you're an income-focused investor eyeing GILD's promising yield like a prospector spotting gold, I'd suggest taking a breath before you stake your claim.
After diving into this company's financial innards with the ruthless precision of a veteran hedge fund manager, I've uncovered some fascinating contradictions.
First off, GILD has undergone a remarkable transformation, shedding its growth-focused biotech skin to become what I call a "mature dividend machine" – offering 9 consecutive years of dividend increases since 2015.
Its current annual dividend of $3.16 per share yields 2.99%, significantly outpacing the biotechnology sector average of 1.92%. Not too bad for a company that cut its teeth on groundbreaking HIV and COVID treatments.
But here's where things get interesting. Despite GILD's revenue looking as seasonal as a summer blockbuster (with predictably lower earnings in the first half of each year), the company's fundamentals show troubling signs beneath the surface.
While Q1 2025 revenue was expected to land around $6.77 billion, the company's economic profitability has fallen off a cliff since 2024. Blame it on negative net income in early 2024 and a Cash Tax Rate that jumped from 25.4% to 30.6% faster than a trader fleeing a market crash.
The historical performance tells an even more sobering tale. From IPO to 2015, GILD delivered average annual returns of 32.25% in 79% of years – performance that would make even the most jaded investor whistle.
But since 2015? The stock managed profits in only 50% of years with an anemic average return of 0.99%, which translates to a 2.17% loss when adjusted for inflation. Ouch.
You might say that the entire sector's going through a rough patch these days, and I would have agreed with you except there are several biotechs still performing well.
Take Vertex Pharmaceuticals (VRTX). Those guys are up 36.7% over the past 52 weeks.
Or consider Amgen (AMGN), whose dividend is growing at a mouth-watering 8.94% annually over five years – nearly triple what GILD is serving up to its shareholders.
Even BioMarin (BMRN), a company most retail investors couldn't pick out of a lineup, has been quietly crushing it with 27.3% revenue growth while GILD's top line moves sideways like a crab with performance anxiety.
And don't get me started on Bristol Myers Squibb (BMY). Despite facing their own patent cliff dramas, they're maintaining a forward P/E of just 7.2 – practically giving away shares – while offering a dividend yield of 4.7%.
So, let me tell you something the glossy investor presentations won't: GILD's forward P/E ratio of 13.35x looks attractively cheap compared to the healthcare sector's 20.13x and the S&P 500's 18.60x.
After having had drinks with several institutional investment managers last week, though, I can assure you that discount exists for a reason.
The smart money has correctly identified that this company is no longer growing profitably, and certain whispers about their pipeline aren't inspiring confidence.
For dividend investors hoping to beat inflation while preserving capital, GILD presents a mixed bag. The dividend growth continues but remains stubbornly below inflation, creating a slow leak in real returns.
And, look, I know the Trump White House isn't exactly making life easy for companies like Gilead. Over whiskey last month with a former FDA bigwig (who shall remain nameless), I heard some concerning murmurs about potential cuts to HIV prevention programs.
Bad news when you're sitting on 40% of the U.S. PrEP market like GILD is.
Bottom line? I'm sticking with "hold" for now. The smart money moves when the smart money knows, and my Rolodex isn't flashing buy signals yet.
I've watched enough biotech darlings flame out to know that patience outperforms panic every time.
When GILD shows signs of recapturing that pre-2014 magic, you'll hear it from me before the CNBC talking heads catch wind of it.
Mad Hedge Biotech and Healthcare Letter
April 10, 2025
Fiat Lux
Featured Trade:
(THE $5 BILLION SECRET I SPOTTED IN MY DOCTOR'S WAITING ROOM)
(AMGN), (NVO), (LLY), (MRK), (REGN)
Last Tuesday, my orthopedist kept me waiting 40 minutes past my appointment time – just long enough for me to witness what Wall Street's finest analysts have somehow managed to miss.
As I sat thumbing through a dog-eared copy of Golf Digest from 2018, I counted eight different patients called in for Prolia injections.
By the sixth one, I'd put down the magazine and started taking notes on my phone. By the eighth, I was already mentally calculating position sizes for my portfolio.
"You know what you just saw?" my doctor asked when he finally saw me. "That's Amgen's cash cow – $5.4 billion in sales last year for a twice-yearly injection. And guess what? Half these patients will be on it for life."
When I pressed him on competing drugs, he just laughed. "Their sales reps bring the best lunches. But seriously, it works, patients tolerate it, and insurance covers it. In medicine, that's the holy trinity."
While half of Wall Street hyperventilates about which pharmaceutical giant will dominate the weight loss market, and the other half chases whatever shiny tech story came out this morning, they're all missing Amgen (AMGN) – a money-printing machine trading at just 14.9 times earnings with a 3.1% dividend that grows like clockwork.
I've been investing in pharmaceutical companies since I covered Merck's (MRK) explosive growth for The Economist in the late 1970s, and one lesson has remained constant: the market consistently underestimates companies with proven track records during transitions.
Amgen, trading at $307, is a textbook example of this phenomenon right now.
The headline numbers don't initially spark excitement – management is guiding for modest 5% revenue growth and 4% EPS growth this year. But having analyzed hundreds of pharma companies over five decades, I know these conservative guidance figures are often the prelude to significant outperformance.
What matters more is their $5.9 billion R&D investment last year (up 25% from 2023) and the underappreciated potential of their pipeline.
Look beyond the surface, and you'll find Amgen has quietly built something remarkable. While everyone's fixated on Novo Nordisk’s (NVO) Ozempic and Wegovy, few have noticed that Amgen's existing product portfolio is delivering solid results.
Inflammation drug TEZSPIRE grew 71% year-over-year and is approaching the $1 billion annual sales milestone. Oncology drug BLINCYTO jumped 41%, and their cholesterol drug Repatha, combined with bone health treatment EVENITY, delivered $1 billion in year-over-year growth.
The real hidden value lies in Amgen's obesity program. The anti-obesity market that barely existed a few years ago has exploded to $2.2 billion and is projected to grow at 30% annually through 2030.
Eli Lilly (LLY) and Novo Nordisk have seen their market caps soar into the stratosphere on the strength of their GLP-1 drugs, but Amgen's market valuation doesn't reflect any meaningful potential from MariTide, their Phase 3 obesity candidate.
This reminds me of 2012 when I began accumulating Regeneron (REGN) while the market was completely missing the potential of Eylea. That position delivered a 580% return over the following three years.
What's particularly attractive about Amgen is the margin of safety it offers. With a 3.1% dividend yield (backed by a manageable 45% payout ratio and 13 consecutive years of growth), a forward P/E of just 14.9, and a fortress-like 46.3% operating margin, you're being paid to wait for the pipeline to deliver.
The company has been aggressively paying down the debt from its Horizon Therapeutics acquisition, reducing long-term obligations by $6.6 billion last year alone.
Their financial discipline stands in stark contrast to many of the speculative biotech plays I've been pitched recently. At a dinner with venture capitalists in Boston last week, I listened to presentation after presentation about pre-clinical assets with billion-dollar valuations and no revenue in sight.
Meanwhile, Amgen generated $33.4 billion in sales last year with industry-leading EBITDA margins of 45%.
Of course, there are risks. The upcoming patent expiration of osteoporosis drug Prolia this year creates a revenue gap that needs filling.
The Trump administration's Department of Government Efficiency (DOGE) initiative could potentially impact FDA testing labs, slowing approval timelines. But these concerns are already priced into the stock, while the potential upside from MariTide and other late-stage candidates is not.
Having navigated multiple market cycles since the 1970s, I've learned that the best investments often come when solid companies are temporarily overlooked during market rotations. Amgen remains a proven pharmaceutical innovator with strong cash flows, growing dividends, and a promising pipeline that offers compelling value.
I started building a substantial position in Amgen at around $260 during the post-election pharmaceutical sell-off and have continued to accumulate shares on weakness.
With a reasonable valuation, strong pipeline optionality, and dividend income that beats 10-year Treasury yields, Amgen represents the kind of steady compounder that has consistently outperformed over full market cycles.
In my decades of investing, I've found that buying excellent businesses during periods of unwarranted pessimism is the closest thing to a guaranteed winning formula.
With Amgen, you're essentially being paid a 3.1% annual dividend to own a company that could deliver a major surprise in the obesity market – the same market that transformed Novo Nordisk and Eli Lilly into two of the world's most valuable companies.
Sometimes the smartest investments are like colonoscopies – nobody's excited to talk about them at parties, but they'll save your financial health in the long run.
Mad Hedge Biotech and Healthcare Letter
February 25, 2025
Fiat Lux
Featured Trade:
(WALL STREET'S MYOPIA IS YOUR OPPORTUNITY)
(REGN), (RHHBY), (AMGN), (AZN), (ABBV), (LLY)
While preparing my presentation for this week's Online Traders Conference, I came across a pattern that made me stop cold. You see, I've been gathering examples of how institutional investors quietly accumulate positions while retail traders are looking the other way.
And there it was, right in front of me - Regeneron Pharmaceuticals (REGN), displaying exactly the kind of setup I'll be warning traders about starting February 24.
You see, while everyone's been obsessing over the latest AI darlings, Regeneron has been quietly crushing it. Their Q4 revenue hit $3.79 billion, up 10.5% year-on-year.
But here's where it gets interesting - they beat consensus estimates by $43 million, and that's with their flagship eye drug Eylea taking a hit.
Speaking of Eylea, let's address the elephant in the room. Its sales dropped 11% to $1.19 billion, thanks to Roche's (RHHBY) Vabysmo muscling into their territory and Amgen's (AMGN) biosimilar crashing the party.
Four more biosimilars are waiting in the wings, held back only by patent disputes. Normally, this would send investors running for the hills.
But here's what the panic-sellers are missing.
Despite Eylea's challenges, Regeneron's non-GAAP EPS still climbed to $12.07, beating analyst expectations by 88 cents.
In fact, they've been playing jump rope with analyst estimates, leaping over them in 10 of the last 12 quarters. Yet their stock price has been doing its best impression of a sleeping cat - just lying there, barely moving.
As someone who's spent decades watching market cycles, I recognize this pattern.
We're in what technical analysts call an “accumulation phase.” While retail investors yawn and look elsewhere, institutional money is quietly building positions.
It's like watching a spring being compressed - boring until it isn't.
But here's what really got my attention: Regeneron just joined the dividend club. Starting March 20, they're paying $0.88 per quarter. Sure, the yield won't make income investors swoon, but that's not the point.
It reminds me of how AstraZeneca (AZN) played it - first, dominate growing markets, then gradually turn on the dividend spigot to attract the steady-money crowd.
They're also backing up the dividend with a $3 billion share buyback program.
With $9 billion in cash and short-term investments, they've got more dry powder than a Revolutionary War armory.
In Q4 alone, Regeneron spent $1.23 billion buying back shares - up 64.1% from last year.
And here's where it gets even more interesting. Their oncology franchise, led by Libtayo, is looking like a dark horse winner. Libtayo sales jumped 50.4% year-over-year to $367 million.
While that might not sound earth-shattering compared to cancer drug heavyweights like Merck's (MRK) Keytruda, Libtayo just pulled off something remarkable.
In their Phase 3 C-POST trial for high-risk skin cancer patients, Libtayo reduced death and disease recurrence risk by 68% compared to placebo.
Even better? Merck's competing trial for Keytruda in the same indication fell flat on its face. In this business, that's like watching your main competitor trip at the Olympic finals.
Looking ahead to 2029, I'm seeing revenue hitting $20.4 billion - think high single-digit growth each year. That would bring their price-to-sales ratio down from 5.12x to 3.53x.
Their non-GAAP EPS should hit $76.5, implying double-digit growth most years. With the stock currently trading at just 14.76x earnings - below most peers like AbbVie (19.06x) and Eli Lilly (64.96x).
On top of these, 2025 is packed with potential catalysts - clinical trial results and FDA decisions that could light a fire under the stock.
Analysts' average target is $929.37, suggesting about 38% upside. But in my experience, when you combine strong fundamentals, multiple growth drivers, and a market that's sleeping on the story, those targets often end up looking conservative.
Remember, the market loves nothing more than a comeback story.
With Regeneron, we might just be watching one unfold in slow motion. The question is: will you be holding shares when the spring finally releases?
For those who want to learn more about spotting these kinds of opportunities, I'll be diving deeper into institutional accumulation patterns at the Online Traders Conference running February 24 through March 1.
But don't wait for my presentation to take a serious look at Regeneron - the smart money isn't.
Mad Hedge Biotech and Healthcare Letter
February 13, 2025
Fiat Lux
Featured Trade:
(TRIPLE-LOCKED AND LOADED)
(AMGN)
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