Pharma is from Mars, payers are from Venus?

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Health care is being reshaped by a move to outcomes and value and payers are leading the way. For pharma companies, navigating the payer landscape at a time of tremendous change poses challenges and raises many questions. To better understand the complex and changing payer landscape, EY conducted a survey of US and European payer organizations and pharmaceutical companies (http://www.ey.com/GL/en/Industries/Life-Sciences/EY-progression-2014) and found there were some common themes. Payers are more focused on cost containment than on outcomes-based approaches to containing costs. While prescription drugs are only about 10% of health care spending, payers see drug costs as their biggest challenge. While pharma companies are generally well aligned with payers’ data needs, one area of disconnect is clinical trial data. Payers want data from comparative trials, but pharma companies are most invested in placebo controlled trials.

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Pharma is from Mars, payers are from Venus?

EY Price Point Q3 2022

Financial questions continued to attract the most attention of the analyst community, with major focus on how companies will respond to the war in Ukraine, elevated commodity prices and improved cash flows. Strategic questions focused on how the changing geopolitical environment will affect capital allocation in the short and long term. Operationally, all eyes were on the capacity of companies to step up asset utilization and bring new projects to market quickly. Explore the latest EY quarterly analysts themes.

Quarterly analyst themes of oil and gas earnings, Q1 2022

The theme for this quarter is rearrangement. The loss, or potential loss, of Russian oil and gas supplies is forcing producers, refiners and traders to rethink the flow of crude oil and refined products from the wellhead to the gas pump in light of sanctions, potential sanctions and the risk of reputational damage. Countries, companies and consumers will all be searching for ways to adapt, and the outcome of the race to bring alternatives to market could alter the global energy landscape for years to come. It is likely crude oil and LNG prices will remain elevated for some time. The process of diverting Russian oil through countries unwilling to sanction it will take time and there is little indication OPEC members are willing (or able) to increase production to make up for the loss of Russian crude. Spare capacity sat at 3.7 mbpd at the end of 2021, just above where it was in January 2020. Currently, sanctioned Venezuelan and Iranian production (about 3 mbpd below their peak) could fill the gap, but political and commercial obstacles remain. At today’s prices, US shale production is attractive, but the fastest the industry has been able to grow is between 1mbpd and 2mbpd per year. The LNG infrastructure was already stretched before the war in Ukraine and there is little prosect of finding new supplies soon. As the largest buyer of Russian energy, Europe will be the epicenter. There is a deeply embedded bias there in favor for renewable energy, and the current crisis is certain to result in an all-out effort to accelerate the build-out of wind and solar power. The capacity to add new green energy is limited though by the project pipeline and supply chains for solar panels and wind turbines, and it is likely that much of the shortfall will be made up with the new LNG infrastructure.

EY Price Point: global oil and gas market outlook, Q2 | April 2022

As the last quarter of the second pandemic year draws to a close, we continue to see heightened contrast between the medical and economic points of view. While COVID-19 cases are close to their all-time highs, so are equity prices, and a leading investment bank declared (on 2 December, 2021 after the Omicron outbreak in South Africa) that it was “optimistic about the possibility of a vibrant 2022.” When news of the variant hit in late November, the markets were rocked by the prospect of yet another round of local mobility restrictions and an interrupted return to normal international travel patterns, on top of the Biden Administration’s announced release of 50 million barrels of crude from the US Strategic Petroleum Reserve. So far though, with OPEC standing by its planned gradual return to normal production, oil prices have stabilized, albeit below where they were in mid-November. Henry Hub prices, always at the mercy of the weather, responded predictably to a warmer-than-normal early winter in the US, falling from US$6.60/MMBtu in early October to below US$4.00/MMBtu by mid-December. In Europe and Asia, following a short reprieve at the start of the quarter, piped natural gas prices have spiked again on concerns triggered by Russian troop buildups on the Ukraine border and uncertainties surrounding the Nordstream 2 pipeline. Looking forward, OPEC and the U.S. Energy Information Administration (EIA) in their last forecasts of the year both projected that 2022 oil demand would be above what we saw in 2019. Although time will tell if those forecasts are realized and other events could intervene, the response to new virus outbreaks is well-practiced and the trade-off between public health and economic reality has tipped toward a cautiously optimistic view.

EY Price Point: global oil and gas market outlook

The theme for this quarter is governed. Apparent market balance at prices that could be sustainable is the product of calculated choices by market leaders and the cooperation of those who follow them. Economics played their customary role as well, with capital scarcity in North America taking about 2 million barrels per day out of the market, about half of the remaining gap in demand. While inventories are close to their pre-COVID-19 levels, there is still uncertainty. The resolution of the pandemic is in sight, but timing is unclear. Vaccine distribution in the US is having an impact but Europe is struggling to contain a third wave of infections. The taps have opened on economic stimulus, but it remains to be seen if policymakers have done enough or if they have overshot the mark. The shape of the crude oil forward curve has fundamentally changed since the end of the last quarter. In late December of last year, the Brent forward curve was gradually increasing while today, the curve is backwardated. This is a clear sign that the market sees a short-term dynamic that is disconnected from the medium-to-long-term fundamentals. The lasting impact of the COVID-19 pandemic remains to be seen. While many have opined that COVID-19 marks a turning point in energy transition, the IEA recently released a five-year forecast of oil demand that shows steady growth, albeit at rates that are below historical expectations. Gas markets are a paradox. At the Henry Hub and at LNG destinations, demand grows, investment lags and prices will occasionally attract attention. Traders, so far though, are unconvinced and futures prices don’t indicate imminent scarcity at any link in the value chain.

EY Price Point: global oil and gas market outlook, Q2 April 2021

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We enter 2021 on a note of cautious optimism for global health, the world economy, and the oil and gas markets. The first weeks of December brought approval in the US and the UK of the first of several COVID-19 vaccines. The speed with which vaccine development occurred is unprecedented, but certainly welcome. In the weeks following the early November announcement of 90+% effectiveness by the manufacturer of the first approved vaccine, the price of WTI crude oil increased by US$10/bbl to US$48/bbl, the highest level since early March. Sustainability hasn’t returned yet, and whatever time it takes to get the world to normal, it will take even longer for normalization within the oil and gas markets. Inventories remain at historically high levels and, optimistically, it will take until April before inventory returns to levels observed in the preceding five years. That’s an estimate, and there has obviously been some difficulty properly calibrating the expectations of how balance will return and how long it will take. In late November, OPEC met to adjust its output plans because of the anemic rebound in demand. In mid-December, the IEA lowered its demand forecast for 2021 due mostly to continued sluggishness in aviation fuel demand. A mild winter has interrupted a recovery in North American natural gas prices after a run-up motivated by curtailed capital expenditures, upstream activity and production. After an initial meltdown, with cargo cancellations and dramatic price reversal, LNG markets have made a remarkable comeback, and the spread between Asia and Henry Hub has reached a level we haven’t seen in almost three years. It may be the case that interruption in FIDs has brought us to the cusp of a balance that can support reliable returns.

EY Price Point: global oil and gas market outlook

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Oil and gas prices have recovered steadily from their lows and are relatively stable, but that stability is supported by the combination of purposeful withholding of production by oil-producing countries and economic stress on upstream independents. Oil prices closed the quarter roughly where they started it, while refining spreads were down slightly. LNG spreads were substantially higher at the end of Q3 than they were at the beginning of the quarter but are still roughly half of what is generally thought of as sustainable. Going forward, the market will be looking closely at how the economy and demand respond to new developments with respect to a potential COVID-19 vaccine and the US election.

EY Price Point: global oil and gas market outlook (Q4, October 2020)

As we close the second quarter of 2020, in most of Europe and Asia, the first (and hopefully last) wave of the COVID-19 crisis appears to be abating. In the parts of the US where the virus hit early, the profile has largely matched Europe’s, while in other parts, the urge to reopen businesses has trumped the desire to contain the virus and uncertainty looms. In the developing world, the crisis has just begun, but without the economic headroom and resources necessary to contain it. As the crisis unfolded, the effect on oil and gas demand has been predictable but difficult to gauge precisely and therefore difficult to manage. Oil prices have crept up steadily as production has been curtailed through coordinated action (OPEC+) and because of economic reality (unconventional oil in North America). That trend has been subject to momentary spasms when bad news hit the market. It would be understandable if traders were nervous, and it seems that they are. Although nowhere near where it was at the peak of the crisis, option implied volatility is still at historically high levels. Gas markets, without the benefit of coordination on the supply side, continue to deal with the market implications of storage at or near capacity. Interfuel competition in power generation has always provided something of a floor, but those lows have been, and will continue to be, tested.

EY Price Point: global oil and gas market outlook

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Oppenheimer & Co. Inc, co-Head of Healthcare Investment Banking, Michael Margolis, provides H1 Healthcare Financing, Funding and M&A Overview. Table of Contents 1. Broader Market Overview 2. Biotech M&A Market Overview 3. Private Biotech Financing Market Update 4. Key Advice For Healthcare Companies Current State of Play; Healthcare has Underperformed the Broader Market Over the Last Twelve Months; Signal-to-Noise is Getting Worse; Healthcare IPO Activity has Decreased Significantly Since 20–21 Pandemic Levels; Biotech Financing Activity Has Remained Robust in 2024; Biotech M&A Market Remains Incredibly Active; Biotech M&A Market Remains Incredibly Active; Big Pharma Upcoming Patent Expirations; Since November 2023 Oncology has accounted for over half of all M&A; Oncology, Autoimmune / I&I, and CV & Metabolic Remain the Top Areas in M&A; Small Molecule Beats Out All Other Modalities in M&A Despite IRA Concerns; Value of Big Pharma Acquisitions by Therapeutic Area in Q1 2024; Private Financing Market Update; 2024 Private Placement Activity On Track to Approach, If Not Exceed, 2020 Levels; Oncology, Particularly Solid Tumor, Continues to Attract VC Investors; Despite the IRA, Small Molecules Continue to Attract VC Dollars; Preclinical-Stage Companies Make Up Almost Half of Private Placements in 2023; Valuations by Development Stage – 2023; Typical Biotech Investors Remained Active in Q1 2024; 23 $100M+ Deals were Raised in Q1 2024; Biotech Fundraising Momentum Continued into 2024; Key Advice For Israeli Healthcare Companies; Although Israel has Strong Presence on US Public Markets, There is Room to Grow; Telling Your Story Effectively; Interacting with Investors to Build Long-term Credibility; Seven Simple Rules for Pitch Decks;

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