Raphael Stevens

SpaceX nearly doubled its backlog of Starlink in-flight Wi-Fi orders with last week’s United Airlines deal, a company director said Tuesday.
Last week, United announced it would retrofit more than 1,000 planes with Starlink and offer Wi-Fi for free.
Starlink is steadily expanding into the in-flight Wi-Fi market, with previous deals including Hawaiian Airlines and Qatar Airways.

A Starlink terminal installed on a Hawaiian Airlines aircraft.
Hawaiian Airlines

PARIS — SpaceX nearly doubled its backlog of Starlink in-flight Wi-Fi orders with last week’s United Airlines deal, a company director said Tuesday.
“Very excited that we have about 2,500 aircraft under contract now, bringing what was effectively a startup to now what we think is a growing experience that’s going to resonate with all the passengers and the airlines worldwide,” Nick Galano, SpaceX director of Starlink aviation sales and partnerships, said during a panel at the World Space Business Week conference in Paris.

The satellite internet arm of Elon Musk’s space company is pushing into the in-flight connectivity, or IFC, market. Last week, United said it will outfit its more than 1,000 planes with Starlink and won’t charge customers for the Wi-Fi.

Read more CNBC space news

The United megadeal was Starlink’s largest IFC agreement yet. It will also push out United’s existing quartet of WiFi providers — Viasat, Panasonic, Thales and Gogo — as Starlink is installed on the airline’s planes in the next several years.
SpaceX has previously announced in-flight deals and has started service with Hawaiian Airlines, Qatar Airways, Japan’s Zipair, Latvia’s airBaltic and semi-private charter airline JSX.
SpaceX has steadily expanded its Starlink network and product offerings since its debut in 2020. The company initially targeted consumers, but has expanded into other markets, including enterprise services such as aviation and maritime.
There are currently about 6,400 Starlink satellites in orbit that connect more than 3 million customers in 100 countries, according to the company.

Galano touted “the sheer factor of the capacity that we can provide” via Starlink, saying the current satellite constellation is “probably over 100 times what all the legacy systems have provided” due to “over 300 terabits per second worth of capacity today.”
SpaceX continues to increase that capacity as well, launching rockets carrying new Starlink satellites about every three days on average this year, according to the company.

Nick Galano, SpaceX director of Starlink Aviation Sales and Partnerships, center, speaks at the World Space Business Week conference in Paris on Sept. 17, 2024.
CNBC | Michael Sheetz

Galano also emphasized that SpaceX is trying to reduce the time it takes to install new antennas on aircraft. Known as retrofitting, the process is a pain point for airlines that requires taking aircraft out of active service for days at a time in order to upgrade or replace a satellite communications system.
“We’re trying to simplify those installations — innovation is a word we use — to get them done in under a day, which we’ve proven on Hawaiian’s and JSX’s fleets,” Galano said.

By comparison, Delta Air Lines said its satellite IFC retrofits take “on average about three days,” according to Glenn Latta, the airline’s managing director of in-flight entertainment and connectivity. But Latta said Delta’s process, which requires retrofitting 1,200 aircraft, is also more intensive compared with Starlink’s installation on Hawaiian’s fleet, which stood at 66 aircraft in mid-2024, according to a securities filing.
“A retrofit for us is removing the system that’s there … and then you can do your install,” Latta told CNBC after the conference panel. “[Hawaiian] have never had a satcom system, so that’s one of the differences to take into account.”
Delta, which relies on Viasat for in-flight service, said in early 2023 it would make its Wi-Fi free to members of its frequent flyer program — a decision that Latta says has proven to be well worth it to the airline. Both Delta and United are in a battle for high-end customers.
“We’ve gotten 3 million additional SkyMiles members as part of our loyalty program by offering free internet access,” Latta said.
— CNBC’s Leslie Josephs contributed to this article.

Don’t miss these insights from CNBC PRO More

The United Auto Workers union on Monday said it had filed federal unfair labor practice charges against Stellantis.
The UAW alleged the automaker had violated contract terms and is attempting to move production of the Dodge Durango out of the U.S.
The charges are the latest action by the union against Stellantis, which has drawn the ire of UAW leaders for production cuts, layoffs and other actions.

United Automobile Workers (UAW) President Shawn Fain speaks on the first day of the Democratic National Convention (DNC) at the United Center in Chicago, Illinois, on August 19, 2024. 
Mandel Ngan | AFP | Getty Images

DETROIT — The United Auto Workers union on Monday said it had filed federal unfair labor practice charges against Stellantis for allegedly violating contract terms and attempting to move production of the Dodge Durango out of the U.S.
The charges are the latest action the union has taken against Stellantis, which has drawn the ire of UAW leaders for production cuts, layoffs and other actions since the two sides reached a new contract last year.

“In our 2023 contract, we won major gains, including a commitment to reopen an idled assembly plant in Belvidere, Illinois, and to build the Dodge Durango in Detroit. We also won the right to strike over those commitments, if we have to,” UAW President Shawn Fain said in a statement. “Now, Stellantis wants to go back on the deal. As a united UAW, we intend to enforce our contract, and to make Stellantis keep the promise.”
Stellantis, which has delayed plans for the Illinois plant, did not immediately respond to a request for comment.
The company argued lin August that it “has not violated the commitments made in the Investment Letter included in the 2023 UAW Collective Bargaining Agreement and strongly objects to the union’s accusations.”

Read more CNBC auto news

The union said several UAW local chapters covering thousands of members have also filed contract grievances over what they allege is the company’s attempt to move Dodge Durango production out of the U.S., allegedly in violation of the UAW’s national agreement. 
The union did not disclose when the attempted move occurred or where the company allegedly wanted to move Durango production.

A UAW spokeswoman cited media reports about the vehicle potentially being moved to a plant in Ontario, Canada.
A copy of the latest National Labor Relations Board filing provided by the UAW did not mention the Durango. It accused the automaker of “refusing to provide the Union with relevant information.”
The NLRB confirmed the UAW’s filing. The union has multiple open charges against several automakers in the U.S.
The UAW said Monday it has more than 24 open grievances against Stellantis regarding the company’s product and investment plans disclosed as part of the union’s contract with the automaker. More

Fashion designer Michael Kors testified Monday about competition in the handbag industry.
The Federal Trade Commission is seeking to block Tapestry’s $8.5 billion acquisition of Capri, which would put six brands including Michael Kors and Coach under a single company.
The trial is expected to wrap up on Tuesday.

Designer Michael Kors poses backstage before the Michael Kors Collection Fall 2017 runway show at Spring Studios in New York City on Feb. 15, 2017.
Dimitrios Kambouris | Getty Images

NEW YORK CITY — In a federal courtroom on Monday, storied fashion designer Michael Kors spoke about the steep challenge of staying relevant in a world where brands can rise and fall based on viral TikTok videos and photos of handbags on the arms of celebrities such as Taylor Swift and Beyoncé.
Kors kicked off the week of testimony in the antitrust trial in Manhattan as a Federal Trade Commission lawsuit seeks to block Tapestry’s $8.5 billion acquisition of Capri. The deal, if approved, would put six fashion brands under a single company: Tapestry’s Coach, Kate Spade and Stuart Weitzman, with Capri’s Versace, Jimmy Choo and Michael Kors. 

The FTC on Monday called Kors, who founded his namesake brand in 1981 at age 22 and still serves as its chief creative director, to testify. Yet, in his remarks, Kors described how even legacy brands like his own can struggle and lose shoppers’ interest.
“Sometimes you’ll be the hottest thing on the block,” he said. “Sometimes you’ll be lukewarm. Sometimes you’ll be cold.”
He acknowledged that his namesake label has fallen from favor and needs a refresh.
“I think we’ve reached the point of brand fatigue,” he said.
The FTC has argued that the combined companies, particularly with Coach and Michael Kors under the same owner, would create a bag behemoth with the power to hike prices for customers while offering them the same or worse products.

Attorneys for Tapestry and Capri, on the other hand, have questioned the FTC’s depictions of a consolidated handbag market. They have said competition has grown as customers consider both pricier luxury brands and lower-priced fast-fashion names, and can shop from online-only platforms and secondhand marketplaces.
The trial comes as consumers balk at high prices and when the outcome of the closely watched U.S. presidential election could change the federal agency’s strategy.
Shares of Capri, which includes Michael Kors, reflect the tougher stretch that the designer Kors described. As of Monday afternoon, the company’s stock has fallen about 24% so far this year. That trails far behind the roughly 18% gains of the S&P 500 and the approximately 17% rise of Tapestry.
In its most-recent fiscal quarter that ended in late June, Michael Kors’ revenue dropped 14.2% on a reported basis or 13.3% on a constant currency basis compared to the year-ago period.
Kors said he remains a student of the fashion industry and draws inspiration from spending time on store floors, talking to customers or people-watching at places such as airports. Even as an industry veteran, he said he must move nimbly.
For instance, he said he learned about Aupen, a handbag industry newcomer, when he saw a photo of Taylor Swift carrying one of the company’s handbags. When he went to the company’s website, it crashed, he said.
“It shows you the power of women like this,” he said.
In another testimony on Monday, former Macy’s CEO Jeff Gennette said retailers also feel it when brands lose some of their shine. Gennette, who retired early this year, said the department store’s sales got hit because it leaned too heavily on Michael Kors’ brand. He said the markdown of Michael Kors’ handbags contributed to “a bad spiral Macy’s was living through when I was there.”
The antitrust trial is expected to conclude on Tuesday with testimony by economists, including one for the FTC and one for the companies.

Don’t miss these insights from CNBC PRO More

Cable giant Charter Communications, under the brand Spectrum, is unveiling new pricing and customer service changes meant to prove its commitment to reliability.
The changes come as cable providers are experiencing major shifts in their broadband, TV and mobile businesses.
Broadband, the bedrock of the cable industry, has experienced a slowdown in customer additions. Meanwhile, the fledgling mobile business has rapidly grown.

Christopher L. Winfrey, CEO of Charter Communications.
Courtesy: Charter Communications

Charter Communications CEO Chris Winfrey said he wants customers to think of reliability and credibility when they think of their cable and broadband provider.
The cable giant told CNBC it is unveiling a series of changes Monday to bolster that goal, including rolling out new bundles and pricing, increasing internet speeds, offering credits for service outages and promising heightened reliability for customers.

Charter — which provides broadband, cable TV and mobile services and is known to customers under the name of Spectrum — said it is also trying to make the company more approachable and remove the longtime negative connotations around cable companies by announcing Spectrum’s new “first-of-its-kind customer commitment,” branded as “Life Unlimited.”
The rollout comes as Charter and its industry peers contend with several trends: slowing broadband customer growth, continued defections from the cable TV bundle, and a young but speedily expanding mobile business.

“It is hard to be loved when you’re providing a critical service to the household that’s a physical infrastructure that charges over $100 a month,” Winfrey said in an interview with CNBC. “And to the extent there’s a problem, sometimes somebody has to enter your home … in the same vein that it is for an electrician or plumber.”
The first step to changing a less-favorable consumer view is with “pricing and packaging that creates more value than you can replicate anywhere else in the marketplace,” he said.
Spectrum said it will charge as low as $30 a month for its 500Mbps internet plan, or $40 a month for 1GB service, when either are bundled with two mobile lines or cable TV. The company is also increasing the baseline internet speed for current customers at no additional cost.

The company also said it’s planning to be upfront about costs. Under its new plan, taxes and fees are baked in, there are no annual contracts and pricing is guaranteed up to three years, it said. Charter even eliminated the 99 cents it had tacked on to most of Spectrum’s pricing in the past.
In addition, Spectrum pledged to give customers credits when the company’s customer service doesn’t live up to its promises, or for internet outages that are out of the customer’s control but are due to an issue on the company’s part and last more than two hours. Service issues such as those caused by weather, natural disasters or power outages don’t count.
Life Unlimited — a new platform for Spectrum’s internet, mobile and TV services — will roll out across its 41-state footprint this week, the company said.
“We wanted to make a bold statement about our commitment and our capabilities,” Winfrey said. “We also wanted to recognize that we’re not perfect and we’re putting ourselves under pressure, concrete pressure, to make sure that we can be a better service operator every month and every year from here on out.”

Pricing power

The Charter Communications logo is displayed on a smartphone.
Sopa Images | Lightrocket | Getty Images

The announced changes are some of Charter’s biggest moves since Winfrey took the helm as CEO in December 2022.
He followed Tom Rutledge, who held the post for a decade and turned a relatively small cable operator into the second-largest cable company in the U.S. through the takeovers of Time Warner Cable and Bright House Networks in 2016. Winfrey was CFO at the time and spearheaded the mergers.
Winfrey recalled the various investments and advancements cable companies had made over the years: namely in broadband, but also in the pay TV bundle and the landline and mobile phone businesses.
“For all the value that the industry’s brought over the years, and the service and reliability investments that we’ve made, we haven’t always gotten the full credit that we deserve, and in some cases, we did get the credit we deserve because we could have done things better,” Winfrey said.
He entered the top job at a moment when it was clear growth was unlikely to return to the cable TV bundle.
Winfrey had been a low-key and not widely known executive in the media industry, but he started off swinging.
At an investor day in December 2022, Charter announced an aggressive capital investment plan that included putting $5.5 billion over three years in its broadband infrastructure network. The higher-than-expected spending during a time of growing competition from 5G wireless providers sent alarms through Wall Street, and the stock dropped.
Charter’s stock price has fluctuated greatly in recent years. On Sept. 12, 2021, the stock price was $787.12. It closed at $340.17 on Friday.

Stock chart icon

Charter’s stock has fluctuated in recent years as there’s been a slowdown in broadband subscriber growth.

That’s in part because broadband customer growth at providers including Charter and Comcast has struggled, according to the companies’ earnings reports. Increased competition from wireless companies such as AT&T and Verizon has also played a role in the stagnation, as has the slowdown in the buying and selling of houses due to high interest rates.
The third quarter was the worst ever for broadband industry subscriber losses, according to MoffettNathanson. Charter lost 149,000 subscribers and had a total of 30.4 million residential and small business broadband customers as of June 30, according to its second-quarter earnings report.

While the losses weren’t as substantial as analysts had feared, Charter’s growth bright spot is now its mobile business, which launched in 2018. Spectrum Mobile has 8.8 million total lines and has grown rapidly due to enticing promotional deals and increased mobile usage on reliable Wi-Fi networks, the company said.
In late 2022, Charter announced its “Spectrum One” plan, the first time it offered broadband, Wi-Fi and mobile in a bundle with promotions that included competitive rates and, in some cases, free mobile lines.
“For wireless, the ‘Spectrum One’ promotion will almost certainly turn out to have been a home run,” analyst Craig Moffett said in a research note in July. “Despite the fact that it was initially viewed as shockingly aggressive, it was, in fact, a rather modest offer.”
Moffett called mobile an “underappreciated growth engine” for Charter, not only because of customer additions but also growth in average revenue per user, or ARPU, which is a metric often used by cable companies.
Winfrey doesn’t expect ARPU to be affected by the new promotions.
“When I think about Wall Street, I think about the customer,” Winfrey said. “If you focus on the customer, provide great customer service, save them money, provide value, then your capital market strategy, your regulatory strategy, all of that just falls into place.”

Tough on TV

A detail view of an ESPN Monday Night Football NFL logo is seen on a tv camera in action during a game between the San Francisco 49ers and the Baltimore Ravens at Levi’s Stadium on December 25, 2023 in Santa Clara, California. 
Robin Alam/isi Photos | Getty Images Sport | Getty Images

Customers have been dropping pay TV rapidly across all providers, including Charter. But the company has been vocal about its efforts to preserve the business, especially under Winfrey’s leadership.
The biggest moment came in 2023 when Disney-owned networks went dark for Charter’s customers and Winfrey called the pay TV ecosystem “broken” as he pushed for a revamped deal with Disney.
While these disputes are common — Disney and DirecTV on Saturday ended a roughly two-week blackout fight — this one was different in the age of streaming.
For Charter, the sticking point wasn’t just the fees. The company wanted Disney’s ad-supported streaming options to be part of its TV offering.
Pay TV providers often say the rates that programming companies such as Disney seek from them are too high, especially since the programmers are also funneling much of their content into streaming platforms. Although the cable bundle loses customers, cable providers note it’s still a cash cow while streaming chases profitability.
“Credit to Disney, eventually they were willing to lean in and they understood their role in the industry,” Winfrey said, adding that ESPN is considered the linchpin of the cable TV bundle. “They had to be the leader in the space, and we knew that.”
The deal allowed for ad-supported Disney+ and ESPN+ to be included in “Spectrum TV Select” packages. In addition, when ESPN launches its direct-to-consumer streaming option — which is expected to debut in fall 2025 — these customers will receive access to it, too.
“I give Charter a ton of credit because they walked into the room and they had very specific ideas. They had a vision that they wanted to execute against, and again, it was a hard negotiation,” ESPN Chairman Jimmy Pitaro said on CNBC on Sept. 3 when discussing the blackout fight with DirecTV.
Depending on the tier a customer subscribes to, their package can include the ad-supported versions of streamers Disney+, ESPN+, Max, Discovery+, Paramount+, AMC+, BET+ and/or Televisa Univision’s Vix.
The deals have also given Charter the opportunity to sell and market the streaming services to its broadband-only customers — and includes a revenue share agreement.
The most recent deals with Warner Bros. Discovery and AMC Networks were early renewals. That’s relatively uncommon in an industry where carriage negotiations often come down to the wire.
Charter last year also started offering its own streaming devices, known as Xumo, through a joint venture with Comcast. The device gets rid of the cable box and gives consumers a way to access both their cable TV and streaming apps in one place.
“We still have hurdles to get through,” Winfrey said, noting that Charter’s goal is to offer all ad-supported streaming apps owned by the major programmers it negotiates with on the cable TV bundle in the first half of 2025.
NBCUniversal’s Peacock is still not part of that roster, however. A Charter representative said the company doesn’t discuss renewals and declined to comment.
Disclosure: Comcast is the parent company of NBCUniversal, which owns CNBC.
Correction: A chart in this article showing changes in residential internet subscribers has been updated. More

More than 30,000 Boeing factory workers began a strike on Friday after overwhelmingly voting down a new contract.
Boeing’s CFO said Friday that the company is focused on conserving cash.
The strike will impact the company’s aircraft production and deliveries.

Workers with picket signs outside the Boeing Co. manufacturing facility during a strike in Everett, Washington, US, on Friday, Sept. 13, 2024. 
M. Scott Brauer | Bloomberg | Getty Images

Boeing announced sweeping cost cuts Monday, including a hiring freeze, a pause on nonessential staff travel and a reduction on supplier spending to preserve cash as it deals with a strike by more than 30,000 factory workers.
Boeing factory workers, mostly in the Seattle area, started walking off the job early Friday after overwhelmingly rejecting a tentative labor deal, halting most of Boeing’s aircraft production.

The manufacturer will make “significant reductions” to supplier spending and stop most purchase orders for its 737 Max, 767 and 777 jetliners, CFO Brian West said in a note to staff. It was the first clear sign of how the strike will affect the hundreds of suppliers that rely on Boeing work.

Read more CNBC airline news

“We are working in good faith to reach a new contract agreement that reflects their feedback and enables operations to resume,” West said in his note. “However, our business is in a difficult period. This strike jeopardizes our recovery in a significant way and we must take necessary actions to preserve cash and safeguard our shared future.”
He added that Boeing is not making cuts to funding for safety, quality and direct customer support work. 

Boeing factory workers and supporters gather on a picket line during the third day of a strike near the entrance to a Boeing production facility in Renton, Washington, U.S. September 15, 2024. 
David Ryder | Reuters

The financial impact of the strike will depend on how long it lasts, but Boeing is focused on conserving cash, West said at a Morgan Stanley conference Friday. He said the company’s new CEO, Kelly Ortberg, wants to get back to the bargaining table right away to reach a new deal.
“We are also considering the difficult step of temporary furloughs for many employees, managers and executives in the coming weeks,” West said.

On Friday, Moody’s put all of Boeing’s credit ratings on review for a downgrade and Fitch Ratings said a prolonged strike could put Boeing at risk of a downgrade. That could drive up the borrowing costs of a manufacturer that already has mounting debt.
Boeing burned about $8 billion in the first half of the year as production slowed in the wake of a near-catastrophic door-panel blowout at the start of the year.

Don’t miss these insights from CNBC PRO More

Bristol Myers Squibb, AstraZeneca, Eli Lilly and other pharmaceutical companies have spent some $10 billion on radiopharmaceuticals acquisitions and partnerships over the past year.
Drugmakers are trying to replicate the success Novartis has found with Pluvicto and Lutathera.
Radiopharmaceuticals are currently available for some neuroendocrine tumors and prostate cancer. They could one day be used for numerous cancers.

Drugmakers are betting that delivering radiation directly to tumors will become the next big cancer breakthrough. 
Bristol Myers Squibb, AstraZeneca, Eli Lilly and other pharmaceutical companies have spent some $10 billion on deals to acquire or work with radiopharmaceuticals makers. They’ve snapped up smaller upstarts to get their hands on technology that, while in its infancy, could treat numerous cancers. 

“Any large company that has a business presence in oncology or for whom oncology is an important therapeutic category will probably need exposure in this area one way or another,” said Guggenheim Securities analyst Michael Schmidt.
Two radiopharmaceuticals from Novartis are already available. Another few dozen are in development, according to Schmidt’s count. It’s hard to estimate the total market opportunity because there are so many possible cancers the drugs could treat, he said.
Schmidt predicts the category could grow to a low end of $5 billion in revenue if the technology stays limited to treating a few types of cancer like prostate and neuroendocrine tumors, to as much as tens of billions if it’s shown to be effective in more cancers.
The drugs work by attaching radioactive material to a targeting molecule that searches for and attaches to a specific marker on cancer cells. The trick is finding markers that exist on cancer cells but not healthy cells. That can allow the treatment to deliver radiation to cancer cells and spare the rest of the body from the level of damage that comes with many cancer drugs. 
Proving the technology could work both scientifically and financially has taken time. The first radiopharmaceuticals were approved in the early 2000s. But interest from large pharmaceutical companies didn’t pick up until recently. 

An employee works at the NSA radiopharmaceutical plant in Aedea Rome, Italy. 
Franco Origlia | Getty Images

Making the drugs requires complex manufacturing and logistics, two major drawbacks. Radioactive material degrades quickly, so patients need to be treated within days of their treatment being made. 
Pharmaceutical companies proved they could manage complex, time-sensitive drugs like CAR-T for blood cancers or gene therapies for rare diseases. Then Novartis showed those strategies could be applied in radiopharmaceuticals. 
The Swiss pharmaceutical giant won approval in 2018 for a radiopharmaceutical drug called Lutathera for a rare type of cancer in the pancreas and gastrointestinal tract. Then in 2022, Novartis secured another approval in the treatment Pluvicto for prostate cancer. Combined, the drugs are expected to reach about $4 billion in sales by 2027, according to consensus estimates from FactSet. 
Those successes sparked broader interest in radiopharmaceuticals. 
“We took all that together and thought, we should do something, we need to do deals here,” said Jacob Van Naarden, president of Eli Lilly’s oncology business. 
Lilly acquired radiopharmaceutical maker Point Biopharma last year for about $1.4 billion, and also signed a few partnerships with companies developing the treatments. One of the most important factors during Lilly’s initial search was whether companies were prepared to manufacture the drugs, Van Naarden said. Radiopharmaceuticals aren’t easy to make, and Lilly wanted to make sure any initial acquisition could produce the drugs themselves instead of outsourcing the work. 
Manufacturing was also a key component in Bristol Myers Squibb’s $4.1 billion acquisition of RayzeBio, said Ben Hickey, RayzeBio’s president. At the time of the acquisition, RayzeBio was nearing completion of a factory in Indiana and had secured its own supply of radioactive material needed to develop the experimental drugs in its pipeline. 
“It was clearly one of the criteria to make sure that we had our destiny within our own hands,” Hickey said. 
Novartis has shown why that’s so important, as the company initially struggled to make enough doses of Pluvicto. It’s investing more than $300 million to open and expand radiopharmaceutical manufacturing sites in the U.S. so it can produce the drug and get it to patients quickly. The company is now able to meet demand for the treatment, which involves careful planning to distribute. 
Each dose carries a GPS tracker to ensure it goes to the right patient at the right time, according to Victor Bulto, president of Novartis’ U.S. business. Novartis drives doses to destinations that are within nine hours from the factory to minimize the risk of disruptions from storms, Bulto said. 
Doctors and patients on the receiving end also feel the complexity. 
Bassett Healthcare Network in upstate New York needed to upgrade its medical license to handle radioactive material before administering Lutathera and Pluvicto, said Dr. Timothy Korytko, Bassett’s radiation oncologist-in-chief. A certified specialist needs to administer the drugs, which are given intravenously.
It can take a few weeks from prescribing a radiopharmaceutical to administering one. For Pluvicto, patients come in once every six weeks for up to six treatments.
Radiopharmaceuticals start decaying once they’re made, so they’re only good for a few days.

Ronald Coy and his wife Sharon.
Courtesy: Ronald Coy

Ronald Coy knows how important it is to make it in for his appointments. Coy, a retired firefighter who’s been battling prostate cancer since 2015, drives more than an hour through upstate New York to receive Pluvicto at Bassett. Coy hasn’t had any issues so far, but he worries a snowstorm could derail one of his appointments between now and the end of January. 
“Hopefully we won’t get any major storms between now and then or if we do, it’s a week before I go,” Coy said.
When Coy comes home from treatment, he needs to take precautions like staying away from his wife Sharon so she’s not exposed to radiation. He drinks plenty of water to remove extra radiation from his body. He doesn’t mind little inconveniences for a few days if it means fighting his cancer.
For Novartis, investing in the infrastructure to produce and distribute radiopharmaceuticals would be worthwhile for Pluvicto and Lutathera alone, Bulto said. But it’s even more attractive because of the potential to treat more cancers. He gives the example of Novartis’ work to develop a drug for a marker that’s found across 28 different tumors, including breast, lung and pancreatic cancers. 
“If we were able to put all these learnings that we’ve developed from a manufacturing distribution in service of patients with lung cancer, patients with breast cancer, and potentially show these levels of meaningful efficacy and tolerability, we’re talking about a very big potential impact on cancer care. And, of course, a very viable business as well,” he said. 
At this point, it’s still an if. The field is in its early days, executives say, and the promise of radiopharmaceuticals beyond the current cancers they treat still needs to be proven.
“If we can be successful in expanding the target and tumor type repertoire, this could be a very big class of medicines,” Eli Lilly’s Van Naarden said, adding that at this point it’s hard to say if the class will be “super important” or “just important.”
One opportunity Bristol Myers Squibb sees is combining radiopharmaceuticals with existing cancer drugs like immunotherapy, said Robert Plenge, Bristol’s chief research officer. AstraZeneca shares that vision.
AstraZeneca spent $2 billion to acquire Fusion Pharmaceuticals earlier this year. Susan Galbraith, the company’s executive vice president of oncology research and development, points to existing regimens that combine immunotherapy with radiation. 
How large AstraZeneca’s radiopharmaceuticals portfolio ultimately becomes depends on its initial prostate cancer program and other undisclosed targets already in the works, Galbraith said. But she thinks the technology will become an important part of cancer drugs in the next decade.
It could take years to understand the true potential of the technology, as many experimental drugs are still in the early phases of development. One outstanding question is whether other radiopharmaceuticals are as safe and well-tolerated as Novartis’ Pluvicto, especially ones that use other types of radioactive material, the Guggenheim analyst Schmidt said. 

Ronald Coy has been battling prostate cancer for almost 10 years. He started taking Novartis’ Pluvicto earlier this year.
Courtesy: Ronald Coy

Large pharmaceutical companies aren’t waiting to jump into the race. Stories like those from Coy encourage them that the work will pay off. 
Over almost 10 years, Coy has undergone multiple treatments for prostate cancer that has spread to his bones. After just one Pluvicto treatment earlier this year, bloodwork showed Coy’s cancer level plummeted. 
Not everyone responds that well to Pluvicto, and things could always change for Coy. But for now, Coy feels fortunate that he’s among the group that responds well to Pluvicto. That’s worth the drives and the precautions for him. 
“I feel very fortunate every day that I am – as it stands now – I’m part of the third where this is working really good for me,” he said.
— CNBC’s Leanne Miller contributed to this report. More