OK, so we now know from the trial data that Olinvo has advantage over morphine for patients with respiratory issues. It's as addictive as morphine. Olinvo provides the anesthesiologist with the flexibility of getting less side effects by lowering dosing -- another possible advantage over morphine.
TRVN's trials used healthy patients, which would tend to minimize showing the relative advantages of Olinvo vs morphine. Let's put CARA aside for a moment: I'm wondering if the entire share meltdown hullabaloo is how big is the respiratory -sensitive market size in surgeries.
Perhaps that's obvious to anyone invested -- but the motivation of my posting on this forum is for the purpose of drawing in commentators who know more than me and are able to cooperatively work to developing an improved investor thesis/awareness. There are a lot of stocks in the world, and I want to invest the right amount into this particular risk, whether it's nothing or a material level of my portfolio.
Back to the question of whether the entire share meltdown hullaboo is relating simply to Olinvo now being sidelined to use for respiratory-sensitive patients, and if I assume for a moment that CARA's pipeline isn't intended to compete with this...
....We just don't know how big the respiratory-sensitive population is, and not even "experts" know....that's because the size of the market isn't just patients who show high respiratory issues. Rather, it's the size of the population where the the anesthesiologist has any concern about this.
That's a fuzzy number. Where Detroit, on SA, might look at the population size showing explicit respiratory symptoms, and see that as the size of the market, that's clearly not how the anesthesiologist is looking at this.
One brother of mine is overweight. I need to lose a lot of pounds, but let's use my brother who is overweight. I don't think of him as having respiratory issues. If he were put in a physically stressful situation, and his body was cut open, I would start to feel a little worried about this. If the hospital said "we're giving him morphine and we'll be monitoring him constantly," I would feel just fine about this -- i.e. the present standard care of morphine.
But, if there's an alternative world where the anesthesiologist can wave a wand and limit the respiratory risk, how cool is that for hospital staff; for my brother's own well being; and the floating anxiety that occurs with anyone in a hospital.
The son of a different brother is scheduled for surgery this afternoon -- at a world famous hospital that does more of these surgeries than literally any hospital. My brother, a primary care physician is traveling the few hundred miles to be there -- that's expected. One of his concerns -- one of his really big concerns -- is that horrible things just happen in hospitals. It's not a safe place, and pathogens, staff distraction and miscommunication happen every minute of every day.
In real settings...in real life use...the anesthesiologist is making a medical and situational judgement as to whether it's worth a minimal extra cost to reduce at least one area of concern.
Where I think Detroit and the most skeptical in the market err is in leaving out of the market share equation the risk-limitation and staff-stress limitation that anesthesiologists will choose in they have a tool to do this.
While in the moment of hearing trial data news that's disappointing, a big portion of the investor market is underwhelmed and even stressed from the market crowd sentiment expressing panic via a collapsing share price, I think it will become clearer as the company moves to FDA filing, and developing it's marketing efforts that the size of the market is based on anesthesiologist strategy, and not patient medical history -- and these are very different sized markets.
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...Which is why the CARA issue looms for me. It's trials were against placebo, whereas Olnivo was against morphine...this makes me wonder if CARA is focusing on a market category that sounds identical to me to Olinvo, but is not identical.
Perhaps someone wants to weigh in, and I will get around to calling the company to see if they'll explain this.
......because, if CARA is not a threat to the use case of Olinvo, at least in the setting last week's trial results were targeted to, then the share price of TRVN is clearly undervalued.
