LianBio Sells Mavacamten Rights to BMS for $350M, Doubling Its Value from $187.5M Initial Investment

On October 24, LianBio announced a collaboration with Bristol-Myers Squibb (BMS) regarding Mavacamten. According to the agreement terms, LianBio granted BMS exclusive rights to develop and commercialize Mavacamten in markets including mainland China, Hong Kong, Macau, Taiwan, Singapore, and Thailand, in exchange for a one-time payment of $350 million from BMS. LianBio's remaining milestone payment obligation of $127.5 million to MyoKardia (a developer of cardiovascular disease treatments, now a wholly-owned subsidiary of BMS) will also be waived.

As a result, as of the time of writing, LianBio's stock price surged 117%, with a current total market value of $324 million.

Mavacamten, developed by MyoKardia, is an oral, cardiac-specific myosin (cardiac myosin) allosteric inhibitor used for the treatment of hypertrophic cardiomyopathy (HCM).

HCM is a chronic progressive disease caused by excessive myocardial contraction and obstruction of left ventricular blood filling, which can lead to debilitating symptoms and cardiac dysfunction, and is one of the leading causes of sudden death in adolescents and athletes.

In addition, HCM patients often exhibit non-specific symptoms that are similar to those of other diseases. Currently, approximately 80%-90% of patients remain undiagnosed. Once symptoms appear, the condition tends to progressively worsen, and in its advanced stages, it increases the risk of atrial fibrillation, stroke, heart failure, and sudden cardiac death.

According to epidemiological data, the global prevalence of HCM in adults is 0.16%–0.23%, which also means that on average, about 1 out of every 500 people has HCM. In China, there are approximately 1.1 to 2.8 million HCM patients. However, there is currently no cure for HCM, and patients can only choose traditional medications such as beta-blockers and calcium channel blockers to alleviate the symptoms of HCM temporarily, with the majority of patients having a poor prognosis. (Data source: "China Hypertrophic Cardiomyopathy Management Guidelines 2017")

Mavacamten is the first drug that acts on the pathophysiology of HCM itself. It reduces the ATPase activity of cardiac myosin heavy chain, reversibly inhibits the binding of cardiac myosin to actin, suppresses excessive myocardial contraction, increases diastolic compliance, and improves energy metabolism. In animal models, treatment with Mavacamten reduced myocardial contraction, eliminated premature contractions, and effectively alleviated the obstruction of the left ventricular outflow tract.

In April 2023, LianBio announced positive results from the EXPLORER-CN Phase III clinical trial of Mavacamten for the treatment of Chinese patients. EXPLORER-CN enrolled a total of 251 symptomatic (NYHA Class II or III) patients with obstructive hypertrophic cardiomyopathy (oHCM).

The trial met its pre-specified primary endpoint, with data showing that the Valsalva LVOT gradient in patients receiving Mavacamten began to decrease as early as week 4 and continued through week 30. At week 30, compared to placebo, patients demonstrated a statistically and clinically significant improvement in Valsalva LVOT gradient (p<0.001). Additionally, the safety results of the trial were consistent with previous findings of Mavacamten in symptomatic oHCM patients, with no new safety signals observed.

These clinical evidence further demonstrate that Mavacamten is an effective treatment option for HCM patients.

As early as 2020, Mavacamten was highly anticipated.

In August 2020, LianBio collaborated with MyoKardia to obtain the development and commercialization rights of Mavacamten in China and other Asian regions for $187.5 million.

In November 2020, BMS acquired MyoKardia for $13.1 billion. At that time, MyoKardia did not have any approved or marketed products, and most of its assets were in the early clinical or even preclinical stages, with only the investigational drug Mavacamten having just completed Phase III clinical development. However, what BMS valued most was precisely Mavacamten.

In April 2022, Mavacamten became the first and currently only FDA-approved cardiac myosin inhibitor for the treatment of adult patients with NYHA Class II-III oHCM to improve functional capacity and symptoms.

In April 2023, the China National Medical Products Administration (NMPA) accepted the NDA for Mavacamten for the treatment of adult patients with symptomatic oHCM and granted it priority review.

In addition, Mavacamten has successively received regulatory approvals for marketing in Australia, Brazil, Canada, the United Kingdom, the Macao Special Administrative Region of China, Singapore, South Korea, and Switzerland, for the treatment of adult patients with symptomatic oHCM.

According to "Cardiomyopathy: Global Drug Forecast and Market Analysis" released by Global Data, the global cardiomyopathy market is expected to grow from $3.07 billion in 2021 to $9.63 billion in 2031. With consecutive approvals, Mavacamten may potentially bring greater revenue in the future.

Previously, Bristol-Myers Squibb (BMS) had three pipelines in the cardiovascular field under research: FXIa inhibitors, for the prevention and treatment of major thrombotic diseases; Danicamtiv, for the treatment of dilated cardiomyopathy; and Milvexian, for the prevention and treatment of acute coronary syndrome, ischemic stroke, and atrial fibrillation.

Evaluate Pharma, a global research institution in the pharmaceutical and healthcare field, once released the list of the top 10 most anticipated new drug launches of 2022, with Mavacamten included. Evaluate Pharma predicts that its sales will reach $1.7 billion by 2026, at which point Mavacamten will become another blockbuster drug for Bristol-Myers Squibb worth over a billion dollars.

The acquisition of Mavacamten will enrich Bristol-Myers Squibb's (BMS) portfolio in the cardiovascular disease field. Adam Lenkowsky, BMS’s Chief Commercial Officer, stated that the collaboration with LianBio will enable BMS to provide high-quality innovative drugs to patients with hypertrophic cardiomyopathy (HCM) and expand the company’s business footprint in China.