>When the new drug is substantially better, it sells itself (with adequate marketing) For instance look how lucentis took share from macugen overnight.<
Agreed that late entrants can do well. However, Macugen is an extreme example inasmuch as it is useless for improving vision, which is the only metric that matters in wet AMD. (I doubt that Macugen would even be approvable today.)
Ordinarily, the differences between competing drugs are not as stark as between Macugen and Lucentis, and hence it requires considerable marketing muscle to take significant share from an incumbent.
“The efficient-market hypothesis may be
the foremost piece of B.S. ever promulgated
in any area of human knowledge!”