Coherus BioSciences, the scrappy biosimilar player turned oncology innovator, has been quietly executing a strategy that seems to have baffled Wall Street. While analysts obsess over quarterly revenue bumps and the growth trajectory of their UDENYCA franchise, Coherus might be subtly setting the stage for a much bigger game with LOQTORZI, their newly approved PD-1 inhibitor for nasopharyngeal carcinoma (NPC).

The Q1 2024 earnings call, ostensibly a celebration of strong performance, offered curious hints about a potential LOQTORZI strategy that could rewrite the rules of oncology marketing. The company's deliberate downplaying of LOQTORZI's short-term revenue potential, coupled with their relentless focus on establishing it as the new standard of care for NPC, suggests a shrewd long-game approach.

Coherus understands that LOQTORZI faces a unique challenge: converting patients currently on off-label PD-1 inhibitors. This is no easy feat, particularly when competing against established giants with entrenched market share. But instead of engaging in a futile price war, Coherus seems to be playing a different game altogether.

They are meticulously building a fortress around LOQTORZI, leveraging its FDA-approved status, inclusion in key guidelines (NCCN, ASCO), and strong physician advocacy to create an aura of undeniable legitimacy. This strategy aims to subtly shift the conversation away from price and towards clinical superiority, a tactic rarely seen in the biosimilar space where price has traditionally been king.

The company repeatedly emphasized that peak LOQTORZI sales will occur around year three. This seemingly innocuous statement could be the key to understanding their long-game strategy. They are essentially saying, "Don't look at the immediate numbers, look at the long-term value we are creating."

Why Coherus' Strategy Could Be Brilliant

Formulary Dominance: By securing preferred listings on key guidelines and aggressively pursuing formulary access in major hospitals, Coherus is building a moat around LOQTORZI. This access advantage will make it increasingly difficult for competitors to penetrate the market, even with aggressive pricing.

Physician Education: By relentlessly highlighting LOQTORZI's clinical superiority (backed by robust survival data and strong KOL advocacy), Coherus is shaping physician perception. This long-term investment in education will pay dividends as LOQTORZI becomes increasingly synonymous with the gold standard of NPC treatment.

The "Washout" Effect: Coherus is patiently waiting for the existing pool of patients on off-label PD-1 inhibitors to complete their current therapies. This strategic "washout" period will create a vacuum that LOQTORZI can seamlessly fill, as it will be the only FDA-approved and guideline-preferred option for newly diagnosed patients.

LOQTORZI: By the Numbers

New NPC patients diagnosed annually in the US - 2,000

LOQTORZI patients in Q1 2024 - 80

NCCN formulary conversion rate by end of Q2 2024 - 55%

UDENYCA: Presentation Breakdown (Q1 2024)

Prefilled Syringe - 90%

Auto-Injector - 8%

On-Body Injector - 2%

Projected UDENYCA Revenue Mix Shift

By focusing on long-term value creation instead of short-term gains, Coherus might be onto something groundbreaking. They are quietly building an oncology empire brick by brick, while the rest of Wall Street remains fixated on the numbers game. The LOQTORZI saga has just begun, and it could be a masterclass in strategic patience and oncology marketing disruption.

"Fun Fact: Coherus BioSciences was initially named BioGenerics, reflecting their early focus on biosimilars. The name change to Coherus in 2012 signaled a broader ambition and a desire to move beyond just biosimilars, a vision that is now coming to fruition with their foray into innovative oncology therapies."