BiQ Journal: Taking a Look at NAMS After the Recent Pullback

I haven't posted to the BiQ Journal for a while, so I thought I'd quickly share my thoughts on NAMS. This information was previously shared in BiQ Chat.

I did some work on NAMS this morning to see if there was a significant opportunity, given the steep pullback in the share price. My take is that it's very binary, based on the outcome of the PREVAIL CVOT, which is coming up for interim analysis in 2027 Q1. If PREVAIL results are positive, there's still plenty of upside from the current EV of around $2.5B.

However, this is a single-asset company heading into a binary pivotal readout in a crowded space. While obicetrapib has demonstrated encouraging data, I think the landscape has changed with Lipfendra's approval. Lipfendra's biomarker-based approval shows the FDA is willing to approve cardiometabolic drugs based on biomarkers without a CVOT. IMO, if NAMS thought they could compete based on biomarkers alone, they would have filed for an accelerated approval (I'm speculating).

The entire thesis is predicated on PREVAIL reading out positive, and the results being strong enough for a BP to have confidence that obi can win market share against the broad field of competitors. This is the same risk I flagged in my earlier post. While the data is encouraging and obi is differentiated, it really all comes down to MACE reduction.

I think there's potentially high upside, but I don't like the R/R compared to other investment options, even after this pullback. That said, for those interested in trading it, I think there's a reasonable to good chance the share price recovers heading into the interim analysis.

NAMS share price at time of publication: $26.98
BiQ ACB: No Position

Please note that the BiQ ACB (adjusted cost basis) includes shares and all open options positions, which are accounted for using a "worst case scenario" assumption, plus realized trading profits (and losses) around my core position.

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