Amgen/Allergan Partners Announce Launches of Herceptin and Avastin Biosimilars

The partnership of Amgen and Allergan made a huge splash in the biosimilar market by announcing the simultaneous US launches of the first two biosimilars of anticancer monoclonal antibodies. The agents Kanjinta® (trastuzumab-anns) and Mvasi® (bevacizumab-awwb) were officially made available July 18.

The move occurred almost simultaneously with a court denial of Genentech’s request for a restraining order against Amgen. For Amgen, this marks the first two biosimilars to reach commercialization.

The launch discounts associated with these two agents is only 15% off of average wholesale price (AWP), but the manufacturers point out that is still significantly below the average selling price (ASP) of the two reference drugs—13% lower than that for Herceptin® and 12% lower than that for Avastin®. This pricing does not include potential rebates or discounts that could further reduce the net costs of these biosimilars.

The launch timing raises the question of when the FDA-approved biosimilar competition will be launched. Other biosimilars in the trastuzumab space have signed licensing agreements with Genentech, the maker of Herceptin. Their launch dates have not been disclosed. Several biosimilar makers have also signed licensing agreements with Genentech on their versions of Avastin, and their launch dates may be upcoming as well.

Assuming the licensing agreements compel the other manufacturers to pay some percentage of sales or profits to Genentech, this could give Amgen/Allergan an automatic edge in profitability. It is unknown whether the launch timing of Mvasi and Kanjinti, have any implications for the existing licensing agreements. For example, it may be possible that an early launch by an unlicensed competitor could negate specific clauses of these contracts.

The bevacizumab biosimilar class progress had stagnated through court proceedings and licensing agreements. In a post from January 2019, we had noted that Amgen had notified the court that it was prepared to launch as early as April 2018.

On the trastuzumab side, Amgen/Allergan’s product was the most recently approved biosimilar (in June 2019).

In their joint press release, they quoted Paula Schneider, CEO of the Susan G. Komen Breast Cancer Foundation. “The introduction of biosimilars is an important step in increasing options for treating HER2-positive breast cancers, which account for about 25% of all breast cancers,” she said. “As patient advocates, we are working to ensure that patients are educated about biosimilars and understand that these FDA-approved treatments are just as effective as the original biologic drugs.”

Apotex/Apobiologix: Success in Canada, but Are They Shelving Biosimilars in the US?

Apotex has recently made news in Canada, introducing biosimilars and obtaining marketshare there. However, the story of Apotex and its Apobiologix biosimilar subsidiary in the US is less positive.

Apobiologix

As we’ve listed in our updated table, Apotex had originally filed for approval for its pegfilgrastim biosimilar with the FDA in late 2014 and its filgrastim biosimilar in early 2015. In 2019, no announcement has been made with regard to the filing status of either biosimilar.

In April 2018, we spoke with Apobiologix executives, who told us that the company “were still in discussions with the FDA” about the path forward for its G-CSF biosimilars. Unfortunately, this statement has not changed at all on its website. If there were discussions, they didn’t go far. And so the mystery continues.

There is some support for the view that the parent company is seeking to shed the Apobiologix subsidiary, and has been actively seeking a buyer for some time. This would make sense to a degree, as any of its newly approved biosimilars would be facing a difficult crawl to US marketshare, being the third or fourth filgrastim or pegfilgrastim biosimilar to launch.  Realizing that its marketshare potential would be substantially limited, why spend the additional developmental dollars?

In April 2018, Canada had granted the company approval to market its pegfilgrastim biosimilar (Lapelga™), and in Canada’s provincial systems, it has become a dominant player. Filgrastim was approved in Canada in 2016 (and in the EU in 2014).

According to its website, Apobiologix had been developing the following products for the US market:

  • Epoetin alfa (reference drug, Epogen®), in Phase 3
  • Darbepoetin alfa (Aranesp®), in preclinical study
  • Bevacizumab (Avastin®), in Phase 1
  • Rituximab (Rituxan®), in Phase 1
  • Trastuzumab (Herceptin®), in preclinical study

Although the pipeline lists the epoetin, bevacizumab, and rituximab biosimilars in clinical trials, no mention of any of these specific investigations can be found on www.clinicaltrials.gov, under Apotex or Apobiologix as a sponsor. A request for comment from Apobiologix was not answered by the time of this publication.

If this is the case, it is less the FDA than the parent drug maker who has lost faith in their biosimilars’ potential in the US. We can ill afford fewer active players in this market.

A Profile of a Lesser-Known Player in the Biosimilar Space: Bio-Thera Solutions

On occasion, we profile some biosimilar manufacturers about whom our readers may not be familiar. This generally refers to companies that have products that are in earlier-stage research or those who simply have not been in the news as often as their colleagues. In this post, we highlight a Guangzhou, China–based company, Bio-Thera Solutions.

Established in 2003, Bio-Thera Solutions “is dedicated to researching and developing innovative and biosimilar therapeutics for the treatment of cancers, autoimmune, cardiovascular diseases, and other serious medical conditions.” It claims several biosimilar and innovative therapies in its pipeline. According to its website, Bio-Thera’s leadership team members spent extensive time in the US. The CEO and Founder Shengfeng Li was also a founder of a California company Abmaxis, which was acquired by Merck, and worked at COR Therapeutics, which became part of Milennium. Chief Medical Officer Li Zhang worked for eight years at the Food and Drug Administration’s Center of Drug Evaluation and Research.  

Why you may be hearing more about this company: Bio-Thera has advanced one of its key molecules, a biosimilar of bevacizumab (reference product, Avastin®) into a phase 3 study against EU-licensed Avastin. The company’s objective is to file a 351(k) application for this product, BAT-1706, with the US FDA and the European Medicines Agency in 2020.

The company announced a new partnership with Mumbai, India-based Cipla Ltd, to market this product in emerging markets. It is not yet known whether Bio-Thera intends to partner with another organization to market in North America or attempt to build its own sales structure.

Other products in research and development include an adalimumab biosimilar (BAT-1406), for which an application for approval has been filed for the Chinese market, and a phase 1 tocilizumab (Actemra®) biosimilar (BAT-1806) for the treatment of autoimmune diseases. The company’s information does not indicate whether either of these products will be targeted for the US market. In a 2018 press release, Bio-Thera indicated that biosimilars of secukinumab (Cosentyx®), golimumab (Simponi®), and ustekinumab (Stelara®) were also in the pipeline. Regardless of the success of its bevacizumab and adalimumab biosimilars, the company seems to be well-aligned to address patent expirations of next-generation biologics.

In other biosimilar news… Regulatory Focus reported Pfizer’s announcement that the drug maker has reevaluated its biosimilar drug pipeline. It has dropped plans to develop 5 biosimilars in preclinical development. The products themselves were not disclosed and were not listed in earlier available version of Pfizer’s drug pipeline. Five other biosimilars in clinical development will continue moving forward, according to the company. This does not affect biosimilars already approved by the FDA. No reason for the decision was given, other than that this was part of an “R&E investment review.”

An Update on Potential Biosimilars for Bevacizumab

Embroiled in patent litigation, the partnership of Amgen and Allergan have waited for the opportunity to launch Mvasi® since September 2017. During this time, the competition has not been stagnant, with Pfizer moving towards an FDA decision. The next 6 months may prove critical, but when will providers, patients, and payers have access to Avastin® biosimilars? That may be based more on guesstimates than on fact.

Avastin patent litigation

WHAT DO WE KNOW?

(1) Amgen and Allergan received its FDA approval for Mvasi (bevacizumab-awwb) September 17, 2017. The approval covered all of the reference product’s indications. The drug was approved for use by the European Medicines Agency in January 2018.

(2) In court documents filed during its patent battle with Genentech, Amgen had originally stated that it planned to begin marketing Mvasi once the last 8 patents it considered valid expired on December 18, 2018.

(3) Amgen then revised this potential launch date, according to the court filing, saying that it could launch several months earlier, on April 5, 2018.

(4) In either case, the launch has not occurred. According to the Purple Book, Avastin was first approved by the FDA February 26, 2004. That is approximately 15 years, and counting.

(5) The US District Court handling the litigation is expressing impatience with the back and forth between the two parties (read the Judge’s concluding remarks). A trial court date was set for June 2020.

(6) Pfizer completed its phase 3 trial for PF-06439535 in nonsquamous non–small cell lung cancer and filed for FDA approval in August 2018. An FDA decision is expected in the second quarter of this year.

(7) In November 2018, Boehringer Ingelheim completed its phase 3 trial in lung cancer for BI 695502.

(8) Samsung Bioepis completed its phase 3 trial in lung cancer in October 2018 (compared with EU-licensed Avastin).

(9) In addition, Centus Biotherapeutics is scheduled to complete its phase 3 trial in June 2019 as well.

WHAT WE DON’T REALLY KNOW

So much for what we know. Here are some things we know less well.

At a drug pipeline update at the Academy of Managed Care Pharmacy in October 2018, Express Scripts’ Aimee Tharaldson, PharmD, Senior Clinical Consultant—Emerging Therapeutics, offered a projected launch date of July 2019. In an E-mail communication with Biosimilars Review & Report, Dr. Tharaldson clarified that this estimate was based on the anticipated expiration of a key patent on Avastin that month.

Bevacizumab Biosimilars
Aimee Tharaldson, PharmD

When we contacted a senior Amgen executive, he stated that the company declined to discuss potential launch dates.

Goodwin’s Big Molecule Watch, which keeps a close eye on biosimilar-related patent litigation, does not list any ongoing suits between Genentech and Pfizer or Boehringer Ingelheim regarding Avastin (which may be surprising in itself).

We would anticipate that Pfizer will launch as soon as feasible, if they receive an FDA approval by June. Pfizer has an established record of moving their biosimilars quickly to market (e.g., Inflectra® [with Celltrion], Retacrit®, and Nivestym®).

Samsung Bioepis has not yet revealed their plans around an FDA filing for their investigational biosimilar of bevacizumab.

Boehringer had not yet filed a 351(k) application for approval of BI 695502. Comments by Molly Burich, Director, Public Policy: Biosimilars and Pipeline, in our interview last Fall, made it clear that the company is laser focused on bringing its adalimumab biosimilar (Cytelzo®) to market. In fact, this bevacizumab biosimilar was no longer posted on their pipeline at that time.

WHAT WE FOUND OUT

Today, Susan Holz, Director, Communications, Specialty Care, confirmed that the company decided that this agent was not in its strategic plans and it simply allowed the study to be completed. She said, “Boehringer Ingelheim made the decision to terminate all activities related to the BI 695502 program, a biosimilar candidate to Avastin. It is important to note that this decision was not based on any safety or efficacy findings with the investigational medicinal product BI 695502. Boehringer Ingelheim continuously evaluates our business portfolio and assesses potential strategic partnerships to help enhance our pipeline and development capabilities.”

Perhaps several of these unknowns will be resolved by the end of July, and the clouds will lift a bit. I suspect at that time, we’ll be much closer to biosimilar access for this biologic, which racked up $7 billion worldwide in sales in 2017.

Coauthor of Hatch–Waxman Act Attacks the Use of IPR Process for Biosimilars

The Hatch–Waxman Act (officially, The Drug Price Competition and Patent Term Restoration Act of 1984) enabled generic medications to be marketed after branded patent expirations. One of the bill’s cosponsor, Senator Orrin Hatch (R-UT), is now spurring a legislative proposal that would protect reference drug manufacturers from use of the inter partes review (IPR) system. This action would result in further delayed access to lower-cost generics and biologic medicines.

Inter partes review is used by makers of generic drugs and biosimilars to challenge weaker patents. It enables the parties to bypass lengthier litigation through the courts, potentially helping less-expensive drugs reach the market faster than otherwise possible.

Hatch-Waxman Act
Senator Orrin Hatch (R-UT)

Called the Hatch–Waxman Integrity Act, this amendment to the CREATES Act was introduced December 11, 2018 simultaneously into the Senate and the House (by Representative Bill Flores, R-TX). If passed this amendment could significantly limit the ability of generic and biosimilar manufacturers to use the IPR process to speed patent review and litigation.

Seemingly a contradictory stance by Senator Hatch, he believes that the IPR process may too strongly affect the balance between access to medications and biopharmaceutical innovation.

In any case, this proposal would have a very difficult road to passage. First the administration’s current efforts to make biosimilars available as soon as possible runs counter to this bill. Second, the shift to the Democratic majority in the House could be an insurmountable barrier to passage.

In other biosimilars news…Sandoz seems to be entering the biosimilar insulin marketplace, with its agreement to commercialize three different types (insulin aspart, glargine, and lispro) that will be manufactured by the Chinese company Gan & Lee. Sandoz will be responsible for the US and Canada, the EU and Switzerland, Australia and New Zealand, and Japan. In the US, insulin makers can file applications for biosimilar status as of 2020.

Additionally, Pfizer received good news from Europe, receiving a positive recommendation from the EMA’s Committee for Medicinal Products for Human Use (CHMP) on its bevacizumab biosimilar Zirabev (reference product, Avastin®).

Fujifilm Gains Further Exposure in Biosimilar Partnerships

The biosimilar industry continues to make strange bedfellows. In July 2016, I reported in the Center for Biosimilars that a subsidiary of the Japanese camera maker, Fujifilm, had jumped into the biosimilar field. The Indian pharmaceutical company Biocon announced that it has launched its new insulin glargine biosimilar in Japan. Fujifilm Pharma Co, Ltd was named as the partner in this endeavor to commercialize the product in Japan.

Fujifilm Pharma is a producer of diagnostic and therapeutic radiopharmaceuticals, in addition to contrast media. This makes sense, as the parent is in the imaging business. Medical imaging can be a very natural extension of this activity. But biosimilars?

To reaffirm its strategy, Fujifilm announced a new partnership.  Its Fujifilm Kyowa Kirin Biologics subsidiary will manufacture a adalimumab biosimilar in the EU (filed for approval in the EU only) and will be commercialized by Mylan if approved. There is no information about whether Fujifilm will seek authorization to market this biosimilar in the US down the road.

Fujifilm Kyowa Kirin AstraZenecaTo further its chances of commercializing this biosimilar in the EU, Fujifilm Kyowa Kirin Biologics joined a lawsuit in April 2017 with Samsung Bioepis and its partner Biogen. The lawsuit, filed in the UK, sought to invalidate Abbvie’s two remaining adalimumab patents, and the UK court ruled in favor of the plaintiffs, opening the door to marketing next year in Europe. Fujifilm also has a bevacizumab biosimilar (FKB 238) in phase 3 clinical investigation.

The parent company has over 200 subsidiaries, and it can be complicated to track which ones are directly involved. For example, another Fujifilm company, Fujifilm Diosynth, does contract manufacturing of biologics. Yet, the phase 3 trial being carried out on FKB238 is sponsored by Centus Biotherapeutics Limited, which is a joint venture between Astra Zeneca and Fujifilm Kyowa Kirin Biologics. Centus seems to be involved only with the bevacizumab biosimilar, not with the adalimumab agent. Despite this web of intrigue, Fujifilm is not likely to be overexposed in the biosimilar marketplace. It is also unknown whether their efforts will be affected by the recent difficulties of its partners Biocon and Mylan with getting its pegfilgrastim biosimilar approved. It has been reported that Biocon will also benefit from this latest Mylan collaboration.

Amgen/Allergan Score Positive EMA Evaluation, but Launch Will Be Delayed

A couple of noteworthy pieces of news have emerged from across the pond on the biosimilar front. The first involves progress for Amgen’s application for its bevacizumab biosimilar at the European Medicines Agency (EMA). Its drug evaluation arm, the Committee for Medicinal Products for Human Use, recommended approval of the biosimilar on November 9.

Assuming EMA final approval is received, however, Amgen and Allergan’s cancer treatment agent will not be marketed any time soon. The principal European patent is not set to expire until 2022.

Image result for avastin biosimilarIn the US, Mvasi™ was approved by the Food and Drug Administration in September, but its launch is similarly delayed by patent litigation. The main US patents should expire in 2019 (Roche claims to hold 27 enforceable patents). Amgen had filed suit October 6 challenging the validity of the patents in question, but this case may not be heard until late 2018. Amgen has the option of launching “at-risk,” but it has not indicated that it will go this route. Otherwise, the earliest launch may be sometime in 2019.

Several other potential bevacizumab makers have already challenged the patents, according to other reports. These include Boehringer Ingelheim, CelltrionPfizer, and Samsung Bioepis.

In other related news…An announcement will be made on November 20 regarding where the EMA will relocate its headquarters as a result of the Brexit. The Agency will need to complete its move by March 31, 2019, when Britain’s divorce from the European Union is finalized.

Amgen Receives Approval for Bevacizumab Biosimilar

The Food and Drug Administration announced today the approval of the first biosimilar for Roche’s Avastin®. The approval of Mvasi™ (bevacizumab-awwb) represents the first biosimilar approved in the US for the direct treatment of cancer. Amgen is partnered with Allergan in the development and marketing of the new biosimilar.

Its approved indications include:

  • Metastatic colorectal cancer, in combination with intravenous 5-fluorouracil-based chemotherapy for first- or second-line treatment. Mvasi is not indicated for the adjuvant treatment of surgically resected colorectal cancer.
  • Metastatic colorectal cancer, in combination with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy for the second-line treatment of patients who have progressed on a first-line bevacizumab product-containing regimen. Mvasi is not indicated for the adjuvant treatment of surgically resected colorectal cancer.
  • Non-squamous non-small cell lung cancer, in combination with carboplatin and paclitaxel for first line treatment of unresectable, locally advanced, recurrent or metastatic disease.
  • Glioblastoma with progressive disease following prior therapy, based on improvement in objective response rate. No data is available demonstrating improvement in disease-related symptoms or survival with bevacizumab products.
  • Metastatic renal cell carcinoma, in combination with interferon alfa.
  • Cervical cancer that is persistent, recurrent, or metastatic, in combination with paclitaxel and cisplatin or paclitaxel and topotecan.

Like Avastin, Mvasi will carry a black box warning involving gastrointestinal perforations, surgery and wound healing problems, and severe or fatal hemorrhage.

The FDA’s Oncology Advisory Committee had unanimously recommended approval of the agent. No announcement was made by Amgen as to pricing or availability of the new product.

FDA Advisory Committee Unanimously Recommends Approval for Avastin® and Herceptin® Biosimilars

It was a good day for biosimilar manufacturers and a bad day for Roche and its Genentech unit. Following a broadly positive FDA staff review of the first products to directly treat tumors, the Food and Drug Administration’s Oncology Drug Advisory Committee took the expected step of unanimously recommending approval for agents from Amgen and Mylan.

In the morning session, Amgen and Allergan’s ABP-215 was convincingly presented as equivalent to Roche’s bevacizumab (Avastin®), based on  pharmacologic, pharmacokinetic, efficacy, and safety evaluations. Clinical studies were performed in patients with non–small cell lung cancer. The Advisory Committee voted 17-0, recommending approval of the drug for all of the originator product’s nonprotected indications:

  • As first- or second-line treatment of patients with metastatic carcinoma of the colon or rectum in combination with intravenous 5-fluorouracil-based chemotherapy
  • Combined with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy, for the second-line treatment of patients with metastatic colorectal cancer who have progressed on a first-line ABP 215-containing regimen
  • As first-line treatment of unresectable, locally advanced, recurrent or metastatic nonsquamous non–small cell lung cancer in combination with carboplatin and paclitaxel
  • For the treatment of glioblastoma with progressive disease in adult patients following previous therapy as a single agent
  • For the treatment of metastatic renal-cell carcinoma in combination with interferon alfa
  • In combination with paclitaxel and cisplatin or paclitaxel and topotecan for the treatment of persistent, recurrent, or metastatic carcinoma of the cervix

Several questions brought up by the Committee involved the glioblastoma indication, and the drug’s passage over the blood–brain barrier. Progressive multifocal leukoencephalopathy was also mentioned, but this did not deter the Committee from its unanimous vote.

Amgen did not apply for approval for Avastin’s other orphan indications, which are “protected,” according to FDA. If they did want to obtain approval for those, an additional data package would need to be submitted.

Immunogenicity studies did not reveal any material differences between the biosimilar and originator product. In a minor twist, Amgen did the clinical testing of its biosimilar against the EU-licensed version of Avastin, and it had to conduct bridging studies to demonstrate the similarity between the EU version and the US-licensed originator drug.

In the day’s second session, Mylan’s MYL-1401O, a biosimilar version of Roche’s Herceptin (trastuzumab), was evaluated. The totality of evidence, according to the FDA staff review documents, supported the 351(k) application by Mylan. The Advisory Committee agreed, voting 16-0 to recommend the biosimilar for approval for use in Herceptin’s indications:

  • For use as adjuvant treatment of HER2 overexpressing node- positive or node-negative (ER/PR negative or with one high risk feature) breast cancer (1) as part of a treatment regimen consisting of doxorubicin, cyclophosphamide, and either paclitaxel or docetaxel; (2) with docetaxel and carboplatin; or (3) as a single agent following multimodality anthracycline-based therapy
  • In combination with paclitaxel for first-line treatment of HER2-overexpressing metastatic breast cancer
  • As a single agent for treatment of HER2-overexpressing breast cancer in patients who have received one or more chemotherapy regimens for metastatic disease
  • In combination with cisplatin and capecitabine or 5- fluorouracil, for the treatment of patients with HER2 overexpressing metastatic gastric or gastroesophageal junction adenocarcinoma who have not received prior treatment for metastatic disease.

The FDA usually accepts the recommendation of its Advisory Committees in issuing final decisions. However, in late June, the agency rejected Pfizer’s Retacrit despite a 14–1 Advisory Committee vote to recommend, based on potential problems at a manufacturing facility. Mylan’s manufacturing partner Biocon, has recently been cited by French inspectors in connection with its European approval application, for potential problems at its Bangalore plant.

A final FDA decision is expected for Amgen’s bevacizumab biosimilar by September 14, and for Mylan’s trastuzumab biosimilar by September 3.

A Difficult Road Ahead for a “Pure-Play” Biosimilar Maker

On May 30, 2016, I wrote a profile on Coherus Biosciences for the Center for Biosimilars. Based in Redwood City, California, Coherus was founded in 2010 to solely focus on the development and commercialization of biosimilar agents. It does not have any agreements to manufacture or license existing approved products. The firm refers to itself as a “pure-play biosimilar platform company.”

Like several other biosimilar makers, it paired up with marketing partners on particular products outside the US, but it reserved its US commercialization for itself.

Fourteen months ago, which can seem like another age in terms of biosimilars, Coherus had extremely positive prospects. It had a deal with Baxalta to market its late-stage adalimumab biosimilar (CHS-0214) in Europe, Canada, and Brazil and with Daiichi Sankyo to market this agent in Asia. Its version of pegfilgrastim (CHS-1701) was nearing FDA application, and its phase 3 clinical studies on etanercept were yielding good results in rheumatoid arthritis and psoriasis. Coherus had a victory under its belt in the continuing patent battle with Abbvie over Humira®. Finally, it had just announced that it would be adding ranibizumab (CHS-3351) and bevacizumaba (CHS-5217) to its biosimilar pipeline. According to the company, it had more than $400 million available to complete its pegfilgrastim FDA application and its ongoing clinical studies for the biosimilar candidates.

Coherus Logo

That was then. In 2016, Shire, which acquired Baxalta, announced that it was returning its marketing rights to the adalimumab biosimilar to focus on rare diseases. As announced in the past week, Coherus laid off 30% of its workforce (51 employees) and lost Daiichi Sankyo as a marketing partner on its etanercept agent, both likely related to FDA’s rejection of its lead biosimilar, pegfilgrastim.

 

 

 

In its March 2017 financial report, Coherus mentions a nonbiosimilar drug candidate for multiple sclerosis in phase 2b studies (CHS-131), which a separate filing indicated that it is seeking another partner to enable the clinical trial program to progress. The latter document indicates that whereas both ranibizumab and bevacizumab are in preclinical development, “Our goal is to advance at least one of these product candidates into clinical trials in 2017.” However, no mention of any of these 3 products are made on Coherus’ product pipeline.

 

Without the ability to utilize revenues from other products to capitalize the biosimilar development and commercialization program, a “pure-play” biosimilar manufacturer is in a precarious position. It is unfortunate that pegfilgrastim was the first Coherus product to reach the approval stage. So far, no other manufacturer (Sandoz or Apotex included) have successfully obtained an approval on pegfilgrastim. In the best case scenario, it may have been able to market pegfilgrastim, which may have provided needed cash if a subsequent product experienced a problem in phase 3 trials or in FDA review. On the other hand, its remaining 2 late-stage products seem promising.

Indeed, it is a difficult road for biosimilar-only manufacturers. Epirus Pharmaceuticals filed for Chapter 7 bankruptcy in July 2016. One can imagine that with Coherus’ assets and progress, a purchase by a major pharmaceutical player could be in the cards. That might be fortunate for Coherus but unfortunate for the health care delivery stakeholders, including consumers, because new, healthy competition in the pharmaceutical arena is needed. I hope that with a new infusion of capital, Coherus can see it through as a stand-alone manufacturer with approved biosimilars to sell.