TCDA an Under the Radar Gem

I’ve seen posts where Cosmid and Fuma mention Tricida Inc.(TCDA) and so I did some digging. Fuma lists TCDA as a stock he currently owns.

Tricida has developed a drug known as Veverimer (aka TRC101) is a polymer ingested to absorb acid in the stomach and pass it through the feces as a way to help treat Chronic Kidney Disease. I thought to myself wouldn’t an antacid do the trick, but this drug really seems to hit a niche where it absorbs a lot of acid and meets an unmet need. Here’s some highlights about Veverimer (that I hope I got right) from the S-1:

  1. Chronic Kidney Disease (CKD) kills more people than breast cancer or prostate cancer.
  2. 30,000,000 people in the US have Stage 3-5 CKD - 35% are diagnosed.
  3. TCDA believes that they have 550,000 potential patients.
  4. The mechanism of treatment allows for treatment of hypertension, edema, and heart failure.
  5. Excellent Phase 3 data:
    Veverimer: 4% patients receiving this drug had kidney function loss >50%, all 124 patients survived.
    Placebo: 10.8% of these patentients had kidney function loss>50%, 4 out of 93 patients died.
  6. There are no competing therapies.

I have no idea what TCDA will charge for Veverimer, but it looks like a HUGE market to me. The submitted a New Drug Application on 9/4/19 under the FDA’s accelerated approval program. Typically, accelerated approval decisions come in around 8 months.

TCDA is a $1.7B stock. It would seem like an opportune time for a larger pharmaceutical firm to gobble them up. TCDA had an investor day on 10/15, and it has popped about 10% since. This seems like a solid bet, so I picked up a few shares (2%) today. I think this is worth a look.




Thanks bulwnkl. Sending this as email to you since this is OT for Saul’s Board. Do you see any options in TCDA that are worth considering?

Benefited from FMI and ARNA calls

This morning I read that Needham initiated coverage on 5/24/19 with a $50 price target and a peak sales estimate of $1.5B in 2034.



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After reading your post I listened to their investor day presentation and was so impressed with the CEO Gerrit Klaerner, PhD and Medical Affairs Elizabeth Faust, PhD (most recently VP Medical Affairs at Kite) that I opened a starter 2% position. I’ve got some notes from the presentation. Disclosure: I’ve got no medical training.

I have no idea what TCDA will charge for Veverimer, but it looks like a HUGE market to me.

Slide 6 lists
Est. WAC price: ~$2,000 - $3,000/mth
Est. net price (~30% GtN) : ~$1,400 - $2,100/mth
Est. months on drug: ~8

Potential Peak US Revenue ~$14,000 revenue PPPY at midpoint
X~150,000 patients
Over $2 billion / year…

They identified undertreatment of Chronic Kidney Disease (CKD) patients with metabolic acidosis as the key barrier to overcome for launch. Slide 43 shows 79% of patients go undiagnosed.

On their being no competing therapy it seems there is, sort of - not an FDA approved drug but doctors will prescribe diet change and bicarbonate of soda. In Q&A a doctor said this hurts their patients by giving them a huge sodium load. Slide 13 quotes from a study in the UK that said oral sodium bicarbonate appears to be ‘subtherapeutic and not cost effective’. Slide 44 says that in a 2019 study sponsored by Tricida, 15% of chronic metabolic acidosis patients are treated with oral alkali therapy. One of the doctors in Q&A said the sodium introduced is terrible for kidney patients and he also said to visualize putting bicarbonate of soda into a glass of vinegar and that gassy eruption is what happens in the patient’s stomach – very unpleasant.

They are taking steps now to address underdiagnosis and undertreatment. They’ve launched various educational and media plans. They’ll be active in conferences. They’ve got a website with articles, videos, etc. and a link to their Neph+ app to predict the 2- and 5-year risk of kidney failure.

Slide 75 lays out a map and their plan to target 5000 nephrologists at launch with 2 Regional Managers, 10 Division Heads and ~85 Sales Representatives. They also have a team of 20 MSL’s (Medical Science Liasons).

Finally they support their view that their drug will save payers a lot of money.

Sounds good to me.