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Table 24 : Selected PSMA radiopharmaceutical characteristics

Pipelines are at similar stages of development ; supply chains will be one of the defining features of who controls the market

Novartis Locametz

Telix Illucix

Lantheus Pylarify

FDA approved March 2022 December 2021 May 2021 FY22 sales $ 271m * $ 149.7m $ 527.4m

* Pluvicto sales as indication of Locametz sales Source : goetzpartners Research , Company Annual Reports

When the combo of radiopharmaceuticals and immunotherapy are realized , large deals will follow

Continuing acquisitive field waiting for further large deals Radiopharmaceuticals in oncology continues to be an active space in dealmaking . Novartis continued their strategy of acquiring assets with their license of Artios Pharmaceuticals ’ pipeline . As previously mentioned , the importance of supply chain and radioisotope production is paramount to the success of these therapies . Acquisitions are common to support infrastructure like Telix ’ acquisition of Optimal Tracers for production of these isotopes . Companies also in-license antibodies that bind to useful targets such as ITM ’ s licensing of the CAIX antibody from Helmholtz Munich . ( Table 25 ) shows acquisitions and licenses in the radiopharmaceutical market since 2021 . Larger oncology players are also investing in the space often in combination with smaller companies to combine targeted monoclonal antibodies and radionuclide . However , due to the supply chain requirements these are a long way off reaching approval . For example , Bayer ’ s candidates are all Phase I or earlier and likely > 3 years off approval . If radiopharmaceuticals success continues , larger pharma companies will need to play catch up . One method could be making a large acquisition of dedicated radiopharmaceutical companies such as ITM or Telix , especially where ITM has a dominant manufacturing position and a pipeline of products which makes it increasingly attractive , in our view .

Table 25 : Selected radiopharmaceutical M & A

Acquiring Company Full Life Technologies

Telix

ITM Positron Precision Technology platform for PET tracers . N / A Nov-22

ITM Helmholtz Munich Licensing of a CAIX antibody N / A Jan-22

Astrazeneca / J & J *

Fusion Therapeutics

Research collaboration to combine targeted antibodies and radionuclide .

N / A

Nov-20 Bayer Noria Therapeutics Novel pipeline of radiopharmaceuticals N / A Jun-21

* Partnership Source : goetzpartners Research , Mergermarket

Big pharma companies have largely avoided radiopharmaceuticals , but this is changing

Key players Novartis , Johnson & Johnson , and Bayer are the larger key players in radioligand therapy . Despite large companies starting to invest , other than Novartis , they are far behind smaller targeted radioligand companies such as ITM and Telix . Companies follow a general sequential trend of first releasing a diagnostic agent then a paired therapeutic agent . The candidates that are approaching imminent approval are largely prostate based therapies , earlier stage assets are focusing on alpha therapies and other indications in ( Table 26 ). As the stability and safety of radioligand therapy improves and indications expand from neuroendocrine tumours and prostate cancer , we could start to see a flurry of deals in this oncology field .

Please see analyst certifications , important disclosure information , and information regarding the status of analysts on pages 91-94 of this research report .