I posted the following earlier on the Yahoo thread in response to someone who said that the *current* Rx sales for phosphate binders was only 10-20 million.
>>>I have done some homework and some math. The current Rx market for phophate binders in between $10 and $20 million annualy in the US.<<<
I sure would like to see some sort of explaination on how you came up with the Rx figure of 10-20 million dollars. Do you have a link on this? You say you did some math. Take me thru it step by step and tell me how you came to this conclusion. I also have done some math and come up with a figure substaintially higher than you. I'd like to know the details of how you arrived at your conclusion so I can compare your figures to mine. I did quite a bit of websurfing tonight and here's what I came up with.
For all practical purposes there are two widely used phosphate binders in use today. Calcium Acetate and Calcium Carbonate. Calcium Acetate is a prescription drug and the most common version is "Phoslo". A coupla other Calcium Acetate drugs I found refrence to were Calphron and Phos-ex. By and large Calcium Carbonate is an OTC drug/supplement. Tums is one example. A few of the pharmaceutical companies seem to have some of their own special formulations of it also.
For brevities sake I'll herafter refer to Calcium Acetate as PhosLo since it's the most widely prescribed as far as I can tell although I saw no specific numbers.
PhosLo is better at controlling hyperphosphatemia than Calcium Carbonate. PhosLo coincidentally enough is made by Braintree Laboratories. I say coincidentally because you have the word *Braintree* in your username:)
Braintree is not public so I could find no solid numbers on it's PhosLo sales.
I found a webpage where PhosLo was selling for $40 per 200 pills.
The recommended dose is 2 pills taken with each meal. However my general impression from a lot of web surfing was that lots and lots of people had to take 3 or 4 pills with each meal to get desired Phoshporus levels.
So I'll be conservative and go with 2.75 pills at each meal times 3 meals per day times 365 days a year = 3,000 pills per patient per year. 3,000 divided by 200 = 15 bottles of pills per patient per year. 15 times $40 = $600 total cost per patient per year.
Okay the latest numbers I see say there's 220,000 dialysis patients in the U.S. I really do not know what percentage of these patients are on PhosLo and what percentage are on Calcium Carbonate. Soooooo, I'll say it's half and half. My guess is that more are on PhosLo than Calcium Carbonate since it's quite a bit more effective but I'm being conservative with my numbers here. The only reason to choose Calcium Carbonate would be economic reasons. Is anyone out there familiar with the insurance aspect of kidney dialysis??? Doesn't either medicare or medicaid pay for the vast majority of the actuall dialysis treament of these patients??? I think the same may go for the Epogen (Amgen drug) that lots of them use??? What I getting at is if some sort of insurance is indeed paying for patient costs associated with dialysis then it would remove any economic basis for a patient choosing calcium carbonate over PhosLo.
OK, also from what I read the vast majority of these patients are on one Phosphate binder or another so out of 220,000 we'll say 180,000 are.
So *if* half of these people are on PhosLo at a cost of $600 dollars per year that comes to 90,000 X $600 = $54 million.
And then of course you have to add to that the costs of the other half of the people who take calcium carbonate. Sheese, I haven't priced Tums lately:) but it takes a huge amount of calcium carbonate to to the trick. One guy I read about was taking 20 Tums per day and he hated it. On another page I saw that the average amount of calcium carbonate taken by patients was 8-12 grams per day; Which of course would be 16-24 500mg pills, and people just hate taking that many pills. PhosLo from what I read is about twice as effective as Calcium Carbonate per milligram.
So what I would like to now know is how you came up with *your* figures. Your 10-20 million per year seems to be *seriously* low. IMHO I have been *very* conservative on the way I arrived at my numbers and even with the conserative variables I used to come up with those numbers they totally dwarf yours so either you are I need to go back to math 101:) Or at least logical thinking 101:)
Side note...
Others here have mentioned about GELX trying to get an additional indication for Renagel for pre-dialysis patients. A coupla pages I went to expressed a need for phosphate reduction in patients with *mild* renal failure. One page even theorized that if phosphorus was better controlled in pre-dialysis patients that it would extend the time period between being a pre-dialysis patient and a dialysis patient. Personally I also believe that GELX will eventually get this additional indication. Of course even before they get the addition indication, doctors would be able to prescribe Renagel to pre-dialysis patients although I'm not sure about if it would be covered by any sort of insurance.
>>>Profitability hopes should lie with Cholestagel, not Renagel. Sell short after approval await the inevitable let down and get beck in for the cholestagel ride.<<<
Yes Cholestagel will definatly be the biggie in comparison to Renagel. And yes as a biotech with the inherent ups and downs of *all* biotechs, money could at times be made on the short side. But sheese, I can't think of anything that could be riskier to short than a biotech. Sure between now ($17) and Renagel approval the price could/should move up and then drop on the news. (Buy the rumor sell the news as they say) It happened recently with Immunex on their Enbrel drug. But there's no way in the world I could go short GELX when news of a Cholestagel partner could come at about any time. |
