Biotech Values

[dewophile]

agreed
things may also shake out based on how various regimens do in specific patient populations - and there STILL isn't enough data to project accurately. for example GILD may dominate the naïve non-cirrhotic space an 8 week regimen that presumably will also be cost effective given the duration of therapy. they will also get the PI failures offering a non-PI based option. others may do better in experienced patients and cirrhotics where GILD will likely be costlier with a 12 week tx duration (my running hypothesis on pricing is that GILD will offer sofo/led at about 1200 a pill, making treatment for naives 67K - which gives some cover politically since it is at a discount relative to current tx for GT2/3 of 84K. GILD has no need to discount sofo at all while they have a monopoly in this pt population. a 12 week course will run slightly over 100K which is fine for PI failure pts who have really no other options. this maximizes - I think - profit for GILD based on pricing and market share projections)
ABBV may do better then in tx experienced and cirrhotics where they have more competitive pricing to GILD (relative to non-cirrhotic naives where GILD will offer the cheaper 8 week course). ABBV may also do ok in GT1b - hard to argue with 99% SVR. If and when MRK makes it to market they could have a competing regimen in terms of convenience with GILD but perhaps not do as well in various genotypes. for example they ran their 8 week arm in GT1a patients, not the presumably easier to treat 1b subtype. I think this is because of the resistance pattern of their drugs where the only real weak point of MK-5172 is the D168A variant which is only found in GT1b patients, while their Ns5A doesn't cover the Y93N variant (among others) which is also predominantly in genotype 1b. so it could end up that ABBV does best in 1b pts where they can offer a non-ribavirin cocktail with at least as good or better SVRs than the competition and cedes more market share in other subgroups. just some rambling and speculation but point is there could be significant niches where one cocktail holds an edge versus competitors and it's not just a free for all based on price dose schedule etc.