Subject: Re: We all have lost the big picture, current and future sales of Viracept will be the driving factor for the price near term.
Date: Sun, Nov 23, 1997
The Viracept sales will largely be the controlling factor of the price until the pipeline has been recognized.
Three major events have occurred that seemed to have been lost during this price fluctuation. First we had the resistance issues (no surprisises and were largely inaccurate), to the amazing discovery that PIs were not a cure (no kidding), but then a huge discovery that after the onslaught of all the negative publicity, has been lost. Early treatment (hit hard, hit early) has been soundly proven correct. The issue of using suboptimal therapy and
holding PIs back is nonsense. Expect an acceleration of all PIs sales henceforth, for the science will probably not be lost on the physicians and patients as it has on the street.
Secondly, the dual protease therapy (Peter Johnson has been banging this drum for years) concept has come to fruition which has been lost on the street, and maybe even on the famed L. Moss. Dual PIs will be the standard therapy in 98 expanding from the current 15% of all those current on the antiretroviral therapy. This will nearly double the PI market overall and will have a more significant effect on the mkt share of Saquinavir and Nelfinavir, since they seem to have the best combination
possibilities.
-Saquinavir with Viracept resulted an 18%increase in nelfinavir plasma AUC and a 392% increase in saquinavir plasma AUC. When used in combiantion, no dose adjustments are needed. More importantly this will be the best tolerated of the combos.
-Indinavir/Viracept; 83% increase in nelfinavir and 51% increase in Indinavir plasma AUC.
-Nelf seems to be the PI chose for every possible combination.
-Saq/Rit is the combo we know most about and has proven successful for salvage therapy.
This has not been realized by the street for any of these companies. Also since Roche has a vested interest in one half of the PIs on the mkt (nelf and saq), expect them to push the very promising results seen thus far with the Viracept/Invirase combo, a win-win situation for Roche especially outside the U.S.
"Brian Boyle, MD
There is admittedly much we do not know about when and how to use combination therapies of protease inhibitors (PIs) -- alone or in combination with nucleoside or nonnucleoside antiretrovirals -- and much of our current knowledge is based on small pilot studies, according to Dr. John Mellors of the University of Pittsburgh/VA Medical Center. Nevertheless, at the end of the last session on HIV therapy at the worldwide 37th Interscience Conference on
Antimicrobial Agents and Chemotherapy (ICAAC), Dr. Mellors delivered a cogent review of what is currently known.
Dr. Mellors believes that the standard of care in 1998 will be dual PI therapy with some combination of nucleoside and nonnucleoside reverse transcriptase inhibitors (NRTIs/NNRTIs)."
Finally, someone has said that European announcement will likely drive the price up 3 points for 3 hrs. Probably true, but you fail to realize how the price will react in anticipation of the announcement and the long term effect it will have on the sales. 40%, yes 40% of all Crixivans sales are outside the U.S. Not to mention the sizeable chunk of money that Roche pays upon approval (9M) and the the royalties from saq. Much more complicated than 3 poits
in 3 hrs.
Don't sell into tommorrows rebound!
|
