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Saturday, October 21, 2017 5:24:38 AM
1) Cost of treatment: 150K. Given the recent pressures to lower drug prices in the US, plus the uneasy similar task in the EU and with NICE more or less on the same registry, I would go with a 5 year median cost of treatment of 100K.
2) I am ok with such a market share. Let us estimate a median of 30%, because my numbers would not differ much. However, IMO is very wrong to take those who are considered peak sales on potential market share and use a multiple on that without discounting them, as you should make the actual value of your numbers at the moment in which approval is granted. I believe a multiple of 4 or 5 would be good if there wasn't competition ahead, and it is IMO possibile, given the status of other current trials, that the drug could face stiff competition in 5 to 7 years from now (say 4 to 6 years after potential approval). This is why, not considering any of the other trials, I would take a lower multiple of 3.5 on discounted 5 years peak sales (I use a conservative 10% discount/year).
3) Your 300K cases seems not to consider subgroups, and it seems most likely that we will need to. I agree to use the PP stat of 15%, but I would estimate a number of cases/year as low as 150/200K, with a PP of 22,5 K to 30K. On that you apply the potential market share.
This is why I believe it too optimistic, not considering any of the other trials, to assign a potential MC of 5B on L approval alone. My numbers would be more in the range of 1.4B to 1.8B (around 2.7B not considering subgroups IMO). You divide that number for what you believe will be the O/S at the time of approval, and voilà.
Obviously this is all and only my personal opinion.
This all said, please consider that the chances of approval, in my opinion, as not as high, and by far, not as granted, as many people in this message board believe. Anyhow, all of these assumptions are useless right now, let's see results first, then back at modeling.
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