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June 30, 2023
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BLOG: Brent Saunders is back! B+L acquires Xiidra

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Key takeaways:

  • Bausch + Lomb has acquired Xiidra, and other dry eye disease assets, from Novartis.
  • Xiidra may achieve better positioning on insurance and PBM formularies as a B&L product.

Is this what it’s like to be in junior high school when the new kid asks the prettiest girl to the dance?

My phone blew up at 0600 this morning with the news that B&L has acquired Xiidra (and several other smaller assets) from Novartis for $1.75 billion, with a possible additional $750 million if certain sales targets are met. This is the epitome of a blockbuster deal, the kind of deal that made new B+L CEO Brent Saunders a combination rock star/folk hero when he ran, and subsequently sold B+L and Allergan.

Darrell E. White, MD

That Brent is officially back in town!

Man, there’s a ton to unpack here. For those of you keeping count, Novartis bought Xiidra for $4.5 billion (and potential milestone payments of $1.5 billion) from Takeda. Last year Xiidra’s net sales for Novartis were around $550 million. In our new era of generification this compares fairly well with Allergan’s reported $660 million net sales for Restasis (I can’t easily find the figures for Allergan’s generic sales). In typical Brent Saunders style this deal is even more interesting when you look into the details: The entire $1.75 billion is financed by J.P. Morgan. None of the dry powder in the B+L cache was fired to pull off this deal.

B+L now owns the most complete and comprehensive portfolio of dry eye disease (DED) medications in eye care. Xiidra is an established immunomodulator. We should remember that the core tactics utilized by Allergan to build a contracting moat around Restasis originated when Saunders ran Allergan. I expect Xiidra to achieve much better positioning on insurance and PBM formularies as a B+L product (note: Novartis had a very good last 18 months in this regard). B+L has the deepest loteprednol product line in eye care. Anyone who has read my stuff knows that I think loteprednol is an excellent DED medication in any form. My bet is that we see very aggressive moves supporting the Lotemax franchise.

Then there’s Miebo! I’m off today and my plan was to write a post about how I planned to use Miebo when it was available. Miebo is going to be a revolutionary drug, filling a huge unmet need in the treatment of evaporative dry eye disease (eDED). It will be used as a standalone treatment in pure eDED and will be a key ingredient in the treatment of incomplete symptom resolution in pure inflammation-driven DED. Immunomodulators will remain a mainstay in our quiver, at least until or if Reproxalab is out, and Miebo will work in concert with them. Indeed, we may actually learn that immunomodulators work BETTER with Miebo; as Sheri Rowan says, everything dissolves in perfluorohexyloctane. Xiidra and cyclosporine may get an absorption boost when Miebo is added.

That was quite an entrance. My phone is still buzzing 3 hours later. Welcome back to the dance, Brent!

Sources/Disclosures

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Disclosures: White reports consulting for Allergan, Bausch + Lomb and Novartis.