Biotech Values

[DewDiligence]

Re: HCV cocktails

>because there will be cross-resistance to drugs of the same class…<

This is not necessarily true. Moreover, second-line cocktails can contain a class substitution without having to resort to ifn.

>there has so far been significant toxicity with the oral agents.<

You’re painting with too broad a brush. Toxicity of these agents has been dose-dependent and the oral agents currently in development are efficacious at much, much lower doses than the prior generation.

>…you think doctors and patients are going to randomly mix and match various direct antivirals<

They will mix them, yes, but it won’t be random. The mixing will be based on an understanding of the individual drugs, just as it has been for HIV cocktails.

>…interferon and ribavirin will represent novel MOA agents for second line if supplanted as first line<

You seem to be assuming that ribavirin won’t be used in the first line. I’m not making any such assumption; to the contrary, I think there’s a decent chance that ribavirin will be used in a first-line non-ifn cocktail.