The price of drugs in the US remains one of the most controversial issues in the sector. For the third year, we present our discount analysis, which shows the wide gulf between US gross and net sales, exceeding 55% in some cases (AstraZeneca, Novo, Sanofi).
Discount risk is best offset by a differentiated portfolio sold through channels less susceptible to discounting. Roche
and Shire do particularly well here, supporting our Outperform ratings.
We also provide our views on the future direction of rebate levels based on our proprietary Exane 4D analysis.
Companies best positioned to resist incremental rebate pressure in future are Shire, AZN, GSK and PFE. Higher rebate and salesforce spend at Novartis, combined with a deteriorating 4D outlook, reinforces our Underperform.
See full note attached