2025-06-16-Jefferies-Mineralys_Therapeutics（MLYS）_我们高血压支付方调查的关键要点..._21页_3mb

Mineralys Therapeutics (MLYS) - Payer Survey Analysis

Key Takeaways

• Payer Expectations:

  • Lorundrostat expected to be positioned as a 3rd/4th line treatment for hypertension, with prior authorization (PA) and step edits common.
  • 75% of payers use step edits for HTN management; 80% require PAs for later-line drugs.
  • Formulary inclusion: 90% would cover at $5K annual list price, but only 60% at $10K, with higher prices prompting stricter utilization controls.

• Adoption Trajectory:

  • Payers expect gradual adoption with steady increase over time (85% confidence), contrasting market consensus expectations.
  • Forecasted US revenue for 2030: $180M (vs. consensus ~$675M), reflecting access hurdles like step edits, quantity limits, and potential competition with AZN.

• Pricing Sensitivity:

  • G2N discount increases with price: 23% at $5K (expected), 35% at $10K.
  • Higher prices (e.g., $10K) may lead to later-line placement (4th/5th) and more restrictive policies.

• Competitive Landscape:

  • Close competitor: AZN’s baxdrostat (Phase III readout H2 2025); timing and cardiovascular portfolio could influence advantage.
  • May face adoption challenges from payer biases towards lower-priced generics and the need to cycle through first-line options.

• Guidance:

  • Hold rating due to tempered launch expectations and payer-flagged access barriers. Price target $15, implying upside of +5% or higher based on accelerated scenarios.

Additional Insights

• Market Positioning: Later-line positioning paired with generic availability creates challenges for broad uptake. Hyperkalemia risk mirrors existing HTN therapies, which doesn’t appear to deter coverage (unless limited).
• Commercial Strategy Questions:
  • How to navigate utilization management systems with a lower-than-specialty price threshold?
  • How differentiate while managing competition with a similar competitor launching around the same time?