Impatience is understandable but unwarranted. I used to have a coach who would tell us not to worry about what other team is doing. Execute our team's plan at our pace and we'll win the game. Most of the time this was good advice.
There are two good reasons why Dr. Missling is smart to take his time to execute his game plan: it improves the odds of FDA approval and it improves the odds of insurance providers paying for Blarcamesine.
Look at the Covid vaccine. It's proven effective and has saved lives and I'm 100% positive at least 30% of people reading this post will disagree. Humans are naturally skeptical (and rightly so) of anything new approved by the government. More trials = more data = more of a willingness to try something new.
Rett patients may be desperate for a cure, but not if that cure makes quality of life even worse for a patient. Is walking to school or saying a few words for the first time worth suffering from severe diarrhea? I don't know. What I do know is that Dr. Missling's goal is to ensure Blarcamesine gets approved and has enough irrefutable data that insurers have no choice but to cover it. Data collection takes time, and just because someone else is doing it faster doesn't mean they're doing it better.
Besides, being first to market is overrated if you have a superior product. Sony's Betamax was released in 1975, JVC's VHS was released in 1976. Ten years later, Blockbuster started a good run renting VHS tapes, until it was displaced by Netflix. Today, Netflix is being cannibalized by everyone from Apple to Amazon.
Let the Rett patients and parents have their go with Trofinetide. I figure six or twelve months of dealing with diarrhea will be sufficient for at least 21% of ACAD customers to try something new. Eventually word will spread about the superior treatment and the market will reward the victor as it always does.
You seem to want to take Sony's first to market approach. I am glad that Dr. Missling isn't trying to race to be first, nor is he scared about competing in the open market and letting the best drug win.
