Daily Brief Health Care: Mayne Pharma, Beijing Wantai Biological Phar, Akeso, STERIS , Perrigo, BZAM , Kailera Therapeutics, Alamar Biosciences, Legend Biotech Corp and more

• Back on the 21st Feb 2025, Mayne Pharma (MYX AU) entered into a Scheme with US-based pharmaceutical outfit, Cosette Pharmaceuticals, at A$7.40/share. The wheels fell off the deal shortly afterward.
• Cosette issued a “material adverse change” notice concerning a FDA warning/notice (on Nextstellis®) and Mayne’s earnings guidance.  The Supreme Court disagreed. Cosette appealed. The Court has now dismissed that appeal.
• Cosette’s concurrent threat to shut the Salisbury manufacturing plant lead to Treasurer Jim Chalmers blocking the deal last November. Thanks Jim. Absent your intervention, Cosette had no legal out.

• CSI Medical Service represents the top 50 largest and most-liquid stocks involved in medical devices, medical care, medical informatization, and other medical theme from the Shanghai, Shenzhen and Beijing Exchanges.
• We expect five ADDs/DELs for the CSI Medical Service index during the upcoming index rebal  event based on the latest available data.
• Nearly 95% of the reference period is now complete. We currently estimate one-way flow to be US$301mn.

• Akeso (9926 HK) announced the placement of 20M shares for subscription at HK$ 97.76 per share.
• The company intends to use most of the placement proceeds for R&D of innovative pipeline, platform, building of infrastructure and facilities, and commercialization of existing approved products.
• In the near to medium term, the company offers much prospect with ivonescimab,  cadonilimab and others beginning to unleash their full potential. Placement looks attractive.

• Akeso has entered into a Placing agreement to issue 20 million new shares at HK$97.76 each, representing a discount of about 6.90% to the previous day’s closing price (HK$105.00)
• Launching the Placement a month in advance would obviously cause investors to worry about the FDA results on Nov.14th. Does this indicate that Akeso lacks confidence in the FDA results?
• The FDA approval results and subsequent HARMONi-3 data will be the crucial turning point that determines the valuation direction – either to surpass Innovent or fall back to RMB50 billion

• Steris plc is expanding its surgical products portfolio through a $2.1 billion agreement to acquire Xodus Medical, a Pennsylvania-based manufacturer specializing in surgical safety and operating room consumables.
• Announced on October 12, 2026, the transaction would add Xodus’ flagship Pink Pad patient-positioning system and other specialty products to Steris’ established healthcare platform.
• The acquisition comes as Steris reported 7% revenue growth and 6% constant-currency organic growth in its first quarter of fiscal 2027, supported by strength in healthcare consumables and services.

• Perrigo Company is back in the takeover spotlight, and its heavily shorted stock adds another layer of intrigue.
• Reports on October 9 suggested that private equity firm CVC Capital Partners could be evaluating a potential acquisition of Perrigo to combine it with Cooper Consumer Health.
• The speculation follows earlier reports linking German pharmaceutical company Stada Arzneimittel and its majority owner, CapVest, to a possible bid.

• Insolvency and Creditor Protection Under CCAA: Following years of chronic operational cash burn, rapid debt-financed acquisitions (including the merger with The Green Organic Dutchman and the acquisition of Final Bell Canada), and an unsustainable federal excise tax burden exceeding ~33% of net revenue, BZAM Ltd. sought creditor protection under the Companies’ Creditors Arrangement Act (CCAA) on February 28, 2024. With consolidated liabilities totaling approximately CAD 112.9 million—including CAD 32.3 million owed to senior secured lender Cortland Credit Lending Corp. and CAD 9.5 million in unpaid excise duties—equity holders face near-certain total impairment.
• Inorganic Top-Line Expansion Masking Deep Gross Margin Deficits: Although net revenue expanded at a 3-year CAGR of 65.15% (scaling from CAD 21.50M in 2020 to CAD 49.35M in 2022 and reaching an annualized run-rate above CAD 80M in 2023 post-merger), gross profitability remained persistently negative (-56.96% in 2022 and -39.33% in Q3 2023). Relentless retail price compression across the Canadian adult-use market, massive biomass write-downs, and fixed cultivation facility overhead consistently overwhelmed unit economics.
• Asymmetric Downside with Negligible Equity Recovery: Subsequent to court orders granting senior DIP financing priority to Cortland Credit and the approval of a Sale and Investment Solicitation Process (SISP), BZAM stock was suspended and delisted following a failure-to-file cease trade order issued by the Ontario Securities Commission. With secured credit and administrative claims substantially exceeding realizable enterprise asset values, common equity offers zero margin of safety, rendering an Underperform/Sell fundamental stance.

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• IPO Momentum Reverses: KLRA opened 62.5% above issue but has subsequently declined 58.6% from its first trade, closing October 13 at $10.77.
• Clinical Progress Continues: Kailera has completed enrollment in its Phase 3 ribupatide obesity trial, providing an important milestone despite the stock’s weakness.
• Investor Patience Tested: Significant private-market backing has not prevented selling pressure, while potential early-investor liquidity remains an overhang.

• Shares remain above the IPO price, despite falling 38.8% from their October 6 intraday peak.
• Second-Quarter revenue increased 82%, with consumables growth and improving gross margins supporting the platform’s commercial traction.
• Leadership additions did not replace the CEO; premium valuation and possible future share supply warrant attention.

• Legend Biotech Corporation (NASDAQ: LEGN) reached a historic financial inflection point in Q2 2026 by achieving company-wide GAAP operating profitability (15% operating margin, $33.25 million net income), driven by global CARVYKTI net trade sales surging 50% year-over-year to approximately $657 million.
• Commercial expansion of CARVYKTI (ciltacabtagene autoleucel), co-developed and commercialized under a 50/50 worldwide profit-split with Johnson & Johnson, continues to strengthen via label expansion into 2nd-to-4th line multiple myeloma (CARTITUDE-4) and unparalleled long-term durability data (CARTITUDE-2 5-year progression-free survival rate of 50%).
• At a last price of $19.04, Legend trades at an attractive enterprise value to sales multiple of ~2.4x annualized run-rate revenue, backed by $965 million in cash and short-term investments, providing an asymmetric risk-reward profile as the market discounts recent CEO leadership succession and pipeline execution toward in vivo CAR-T (LB2501).

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