All eyes on Regeneron's COVID-19 antibodies, but Dupixent's still driving the bus

Regeneron's bullish outlook for its COVID-19 antibody therapy continues to outpace its sales figures, but strong Dupixent and Eylea revenues in the fourth quarter eased some of its immediate pressure to perform.

The immunology drug Dupixent notched $1.17 billion in sales, a whopping 56% increase year over year, while eye injection Eylea grew 10% year over year to reach $1.34 billion. Total revenue grew 30% in the quarter to $2.4 billion.

Those numbers helped make up for the antibody cocktail's $146 million for the period, which, to be fair, amounted to just six weeks after its November emergency use authorization. Still, that sum fell short of what analysts were expecting—and pales in comparison to the potential laid out by Regeneron.

More is to come, though, Regeneron says: In January, the company signed a deal with the U.S. government for up to 1.25 million doses, an addition to its previous deal, inked in July, for 300,000.

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With doses priced at $2,100—even at the lower treatment dose Regeneron is aiming for—the total payout could be as much as $2.625 billion on the new 1.25 million contract.

But that depends on the uptake. Regeneron will finish up the $466 million worth of doses left on the initial contract in the first quarter, but plans to deliver 750,000 doses on the new contract by the end of June, mostly delivered in the second quarter, CFO Robert Landry said. The U.S. government is obligated for purchases through June, but may accept more doses through the end of September “at its discretion,” Regeneron reports.

Adoption of antibody treatments—both from Regeneron and Eli Lilly—have been hindered by logistics. The infused treatments are administered in clinics or hospitals to mild or moderate COVID-19 patients who aren’t hospitalized, but Regeneron is banking on several developments in the works.

RELATED: Regeneron pitches COVID-19 antibody cocktail for 'passive vaccination' with fresh trial data

Interim phase 3 trial data in January showed REGEN-COV could serve as a “passive vaccine” to prevent COVID-19. The lower dose (1,200 mg injected under the skin) resulted in 100% prevention of symptomatic infection in the trial, which is underway in partnership with the National Institute of Allergy and Infectious Diseases (NIAID).

Regeneron CSO George Yancopoulos said the company sees the antibody cocktail not only playing an important role in treatment in the next several months as vaccinations roll out, but also with new variants emerging.

“We believe the strategic deployment of antibody approaches, such as our REGEN-COV monoclonal antibody cocktail could be targeted in such as way so as to reduce the loss of life over the next six months as well as to provide protection against the possibility of [reduced] vaccine efficacy [and] ongoing disease prevalence,” he said.

SVB Leerink analyst Geoffrey Porges noted that while Dupixent is likely to face competition from AbbVie's Rinvoq with its pending approval in atopic dermatitis in the second quarter, there still plenty of room for both in the space.

He also pointed out another proof point in Regeneron's pandemic rebound in new patient starts for Dupixent now above pre-COVID-19 levels. And Dupixent still has plenty of room to grow in atopic dermatitis—only 6% of the 2.2 million eligible U.S. patients are on treatment, Regeneron executives said in the call.

Regeneron sees further opportunity in the allergy category for Dupixent. EvercoreISI analyst Josh Schimmer highlighted Regeneron's mention of positive phase 2 results in conjunction with Aimmune's Palfozia approved to treat peanut allergies, with data promised at an upcoming meeting, noting it "meaningfully expands the already sizeable TH2 market opportunity."