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Biotech / Medical : VPHM - Viropharma Inc

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To: scaram(o)uche who wrote (127)	7/14/1999 11:54:00 PM
From: Pierre Borczuk	Read Replies (2) of 2557

I don't deny there will be a niche for Pleconaril (there are clearly very ill patients who cannot afford to be tipped over by a viral infection who might be candidates for treatment or even prophylaxis ,if it turns out to be efficacious) . However I think the average person gets a cold, will have symptoms, and may seek medical attention by day 3-5. Seeking medical attention means paying a copay to see your doctor (maybe getting a script via phone without being seen) and then paying for a course of this medicine ( priced like an everage antibiotic probably, like azithromycin $25) Average expense out of pocket $40-50 to treat symptoms that will likely last a couple more days anyway. 14 days of cold symptoms for the average person seems excessive. And these are medians, which means that 1/2 of people have symptoms for more than 14 days in placebo group. My perception of what the common cold is and what this population that is reported upon are at odds. The old common cold saying is that is lasts a week, and with antibiotics only 7 days. My cold started on Friday , worst on sat/sun, and now I have minor and improving symptoms ... there is no interference with work Asthmatics may be sicker for longer periods of time, but this more related to inflammatory response secondary to the infection and not primarily from viral particles. While the "cure for the common cold" sounds good, I think pleconaril will be like acyclovir is now for chickenpox. Acyclovir can be used to decrease duration and quantity of symptoms. However it is indicated for use less than 24 hrs after than rash has appeared. Practically patients present after the rash has been present for several days and are generally not candidates for the drug. I have not read much recently re:pleconaril for viral meningitis ... is VPHM going for a use in documented viral meningitis (ie all patients who have had a spinal tap?) . If so, then this does limit the number of patients who will be eligible for the drug. Pierre

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