US Elections: Vivek Ramaswamy makes brazen debate debut

Last night, the US 2024 election cycle kicked off with the first Republican primary debate involving eight candidates on the stage vying for the role of a frontrunner in the national elections next year.

The televised debates provide a platform for the candidates to state their positions on various national policies, including those for the broader healthcare sector. Given the significant role played by US pharma companies, the potential presidential candidate’s approach to wider corporate tax laws and manufacturing investment can also impact the pharmaceutical sector on a more international level. This year’s primary had an additional pharma connection— Roivant Sciences founder Vivek Ramaswamy.

Ramaswamy, who sold his profile as an entrepreneur, having “found[ed] multibillion dollar companies”, was at the centre of the stage leading in the polls ahead of other seasoned politicians. Ramaswamy is known for founding a network of biotechs or “-vants” like Dermavant, Axovant, Urovant and others that are listed as subsidiaries of the parent company Roivant Sciences. Over the last decade, the companies have raised hundreds of millions of dollars through venture capital and the stock markets, building a pipeline by in-licensing drugs from other companies.

However, only one drug across all companies has crossed the approval line, namely Vtama (tapinarof), which was also licensed by Dermavant from GSK in 2018. Vtama is a topical cream that acts as a therapeutic aryl hydrocarbon receptor modulating agent (TAMA) to treat plaque psoriasis. The drug has also been studied as an atopic dermatitis treatment in Phase III trials, and an NDA is expected in Q1 2024. As per Roivant’s earnings, Vtama gained $16.7m in revenues in Q2.

Another high-profile bet, which had initially contributed to the high company valuations, was the Alzheimer’s drug intepirdine developed by Axovant that failed in a Phase III trial in 2017. Axovant, which raised $315m in an IPO in 2015, later changed its name to Sio Gene Therapies and was most recently dissolved in April 2023.

Florida Governor Ron DeSantis brought up the ongoing fentanyl crisis in connection to other border issues, but the topic was largely ignored in the debate despite rising overdose cases in the country. The closest the debate got to touching on pharma was when Ramaswamy decried “drugging up people in mental health institutions” with psychiatric drugs like the selective serotonin reuptake inhibitor (SSRI) Zoloft (sertraline) and Seroquel (quetiapine) in favour of opening more institutions and calling for a “tonal reset” in several areas.

One notable omission was any discussion of the Inflation Reduction Act (IRA), which was passed last year and is being touted by the Biden administration as a major endeavour to curb rising drug prices. The IRA is said to boost the development of biologics over small molecules, given the longer protection periods for price controls.

This was one of three planned Republican debates before the eventual candidate will be announced at the RNC convention next summer, before the general elections in November 2024. Healthcare costs will be expected to be a hot-button topic in the eventual election cycle given inflationary pressures and the lack of a consensus on ways to deal with it across the aisle.