Stéphane Bancel runs Moderna (MRNA). He thinks investors read his cancer-vaccine data wrong. The stock fell hard when the results came out. Researchers called them a breakthrough. Investors called them a letdown. The shares have since come back a little.
Bancel sat down with the Journal's Xavier Martinez. The vaccine is called intismeran. In melanoma, Bancel says, it added a benefit on top of Merck's Keytruda about the size of the one that first made Keytruda a hit. The data cover two years after the shot. He says an earlier, smaller trial showed an even bigger risk cut at five years, and he expects these numbers to improve with time. Those are his claims. Nothing in the story checks them independently, and the paper gives no approval date. Bancel says Merck and Moderna are getting ready to launch and are training hospitals.
The part that matters for a budget is where the shot is given. Cancer drugs usually go in by IV drip at a hospital, with doctors nearby for side effects. Bancel pictures something else. If the vaccine works in earlier cancers, he says a patient with early-stage lung cancer could walk into a pharmacy every three weeks for nine doses. The side effect, he says, is a vaccine's. Tired tomorrow, maybe a fever tonight. He argues that would save the health system money.
A $200,000 drug and a pharmacy counter
Drugs like Keytruda cost more than $200,000 a year for the average patient, the paper says. They'll face cheaper copies when their patents run out. Bancel says Moderna's won't. Its software reads a tumor's DNA and picks up to 34 mutations to target, and the company hasn't patented or published the method. "We don't want to teach competition," he said. There was a snag in testing. Moderna excluded 17% of the people it screened because it couldn't get enough tumor sample. He also talked up an experimental shot for Lynch syndrome, an inherited condition carried by about a million Americans that raises colon and ovarian cancer risk. An early Oxford trial is testing whether it's safe. "I just prefer to do prevention," he said.
Our read
Health Costs. We're not making a call on Moderna's stock, and we don't hold it in any model book. The planning point is the counter. Medicare pays for drugs two ways. A drug given in a doctor's office or a hospital, like an IV drip, usually falls under Part B. A drug you pick up at a pharmacy usually falls under Part D, with its own deductible, its own formulary and its own yearly cap on what you pay. That's our inference, and the paper doesn't go there. Still, if cancer treatment moves to the pharmacy counter the way Bancel pictures, the bill for the same disease moves to a different part of your coverage.
Here's your check this week, and it's Medicare enrollment season, so the timing works. Pull out your Part D plan's summary and find two lines. One is the specialty-tier coinsurance, your share of a high-priced drug's cost. The other is the yearly out-of-pocket cap. If you're not on Medicare yet, find the same two lines in your employer plan's drug benefit. Those two numbers are what a pharmacy-counter cancer shot would cost you, if it ever arrives. Knowing them now is the umbrella already in the closet. Bring the summary to your next review and we'll read the two lines together.