There are nuances to this excellent idea that are worth mulling over. (1) Yes, it is true that Lovaza is already partially nibbling at Vascepa's lunch. But, this has occurred where mostly gen IPE supply ran out and Vascepa substitution has defaulted to the least expensive "alternative" in third party payor/pharmacy policy -Lovaza. There is also a deep historical base of ever-reliable knowledge deprived prescribers stuck in the ice age of developmental therapeutics, who blissfully commit murder (perhaps manslaughter) by Rx. It will take Time, ruthless Guideline enforcement and more than the average dose of shaming to elicit change here. (2) It may be true that the FDA has an open ear for a PFE or JNJ but it is also the case that GSK has a vast team of representatives who have established access to the ear of physicians already. The same may be said of PFE JNJ Novartis etc...However, targeting their own Lovaza prescribers to upgrade to Son of Lovaza may be a good selling strategy (coupled with the knowledge of why this matters to patients). (3) In the end, for prescribing habits to change the majority of physicians must be convinced of two things categorically and scientifically: DHA is detrimental and EPA is incrementally beneficial. That time is nigh as we will see from the ACC presentations this month. The time is also pressing when a review of this half century's most significant cardiovascular achievements (by 3 cardiology grandees) cannot blatantly and shamefully ignore the immense cardiovascular achievements of Vascepa and REDUCE-IT. Icosapent Ethyl either as Vascepa or as a generic or as a derivative improved product will save millions of lives and prevents countless more strokes, heart attacks, heart failure, but it will take a legal system that doesn't destroy the incentives for innovation and trial, as well as an equitable access to that medication in whichever country of the world. HK Reference: https://www.nejm.org/doi/pdf/10.1056/NEJMp2033115?articleTools=true
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