D. Root writes that he is "wondering how much inroad they really will make with thier first product, levalbuterol.---given that it will invariably cost more than albuterol, and that the regular albuterol is really not that limited by toxicity in most cases"
Remember that levalbuterol not only has a better side-effect profile than albuterol, but there is evidence that, unlike albuterol, its use does not cause long-term decline in lung function.
I think that the best analogy here is Zantac and Tagamet. Zantac, the newer drug, was up against the best-selling drug in the world at the time. Zantac had essentially equivalent effectiveness, but a better side-effect profile. It rapidly overtook Tagamet, and maintains its lead, even though Tagamet is now off-patent and much cheaper.
In the case of levalbuterol, the case is even easier to make. It would seem to me to border on malpractice to prescribe a drug that is demonstrably inferior in both effectiveness and side-effect profile. I assume some HMO's will squawk because of the increased cost, but remember we are dealing mostly with children who have asthma, and my guess is that they will back down pretty quickly. Remember there are claims of an increased death rate among frequent users of albuterol, and although nobody knows if levalbuterol might reverse this trend, it will surely make doctors more cautious about prescribing the inferior drug.
So I think that the company's target of half the $1.5 billion albuterol market is realistic over the medium term (say five years).
Peter |
