@mushroompanda - great points, and I largely agree. This is a "real world" trial (sample) of a company with an interest in promoting its product (and share price). We should certainly be skeptical.

My reason for welcoming it is less because I believe it, and more because I think the "GLP-1 thesis will destroy CPAP" has been given far more credence than it warrants based on the data. So, I celebrate some balance in the discourse (and a SP returning to a fundamentals-basis), even as I also question the scientific rigour of the claims!

My bias is also clear, $RMD is a top-6 RW holding for me.

@mushroompanda don't quite agree with you. yes be sceptical and I suspect some cherry-picking of data. cherry picking will continue on both sides. i took it the other way, not necessarily onboard with positive correlation, but no impact, as implied in your argument, that is, a fair size of the customer base will not be able to afford GLP-1 means status quo prevails. so overall the delta is positive after a big swing towards the death and destruction argument. on the other hand, if MF dumps a huge amount of stock, all bets are off! lol

held

Interesting chart @mushroompanda thanks for posting. ETA: Sorry, I see it was @mikebrisy who posted it. I struggle with the navigation on here sometimes.

I think you are right that taking a cohort of patients with a level of health care gives them access to GLPs means they are more likely able to access multiple treatments for OSA. I'm pretty suss of something held out to be scientific that's slotted into an earnings prezzo, you can make data tell you anything you want if you slice it the right way.

Gent that I bump into every now and then was recently telling me that he has had his jaw reconstructed so he doesn't need to use a CPAP machine anymore. It's a 9 month journey for him back to full recovery. He has to be careful how he drinks water and eats food etc or it can come out his nose at the moment. That's a very high non-financial cost to pay to get off a CPAP machine. Anecdotes aren't data and all that, but I don't think it would take much to get people to switch to something less invasive like an injection. It's not something that plays out over 1 year, it's something that takes 10.

The prices of these drugs will come down substantially over the next few years. There are so many similar drugs in the pipeline. The rebates already on offer for what are brand new high demand drugs shows there is already healthly competition even in a supply constrained market. (The table below is for the US; Wegovy is the only drug approved for obesity at this point which perhaps explains some of its pricing power relative to Mounjaro and Ozempic)

@mikebrisy @Solvetheriddle points taken. And I agree it's good to see Resmed fight back and turning the tide on the popular narrative. I think the "OSA is best treated with weight loss and PAP" is a strong one, and a partnership with Lilly and/or Novo would blow the bear case into smithereens.

Just wanted to point out the data presented is not a clinical trial, and hasn't undergone anywhere near the same rigours. The CEO would be aware of this also - at one point during the call he mentioned that the cohort is likely to be more motivated than the general population because they sought a prescription for GLP-1.

Although when an analyst asked if this would be an increasing tailwind as more people get on the drugs, he didn't confirm or deny the extrapolation.

It's marketing, but a good deal of people are going to interpret it as fact.

Thanks for your thoughts and info @UlladullaDave.

OSA treatment outside of PAP and oral appliances generally involve surgical procedures and are huge prices to pay. From what I understand, they also have a decent failure rate which is doubly sad. On the other hand, doing nothing about severe sleep apnea is also a death sentence.

On a related topic. Acquired did a fantastic 3-hour podcast episode on Novo Nordisk: https://overcast.fm/+_ztzOmHi0

I listened to in recently on a long road trip - switched it on every time my kids fell asleep and couldn't complain. It touches on listed price and the implied net price of drugs. Spoiler alert: insurance companies get huge rebates, so nobody really pays the listed price. I was also surprised how the development on GLP-1s were based on first principles and not something that was stumbled across. Well worth the listen in my opinion.

Pharmaceutical companies have forever skewed data to meet their needs. There are insane number of examples of this. I own RMD shares and purchased a large stake (top 2 holding) IRL during the sell off. I personally do not believe any of it although acknowledge it exists and can assist in developing a thinking process around your purchase.

I firmly believe come March the results of Ozempic on Sleep Apnoea suggest that it benefits those with sleep apnoea. I would be surprised if it does not. The so called scientists around making these one-eyed studies set them up to succeed. I barely even call it science anymore. It is the world we live in where profits and creating shareholder wealth trumps anything else.

I will only sell my RMD shares if or when I see a slowdown in growth that does not meet my valuation. Until then I think all of the rest is just noise.

If you look back at my previous comments on RMD I had a similar thinking pattern around Ozempic and how I thought the studies coming out were all complete rubbish. It enabled me to feel very comfortable making a very large position in this and quickly making near 30% profit in a short period of time.

Not saying to ignore the data being released but be aware of the bias nature of it. I would preference an independent Randomised Control Trial, but no one will fund it as the pharmaceutical companies fund these studies themselves.

DISC: hold RMD IRL