It is hard to compete on efficacy in the osteo market because BMD readings are typically only done once every 2 years, so you basically give the drug and assume that it works if the patient can tolerate it.
Yes, it is hard but when it is done like with Fosamax, long-term efficacy data are one thing that made it the leading bisphosphonate.
... but triggers for therapy change [in the osteo market] are primarily cost, convenience and tolerability, not efficacy.
I think we agree docs will go on prescribing oral bisphosphonate in 1st line primarily due to cost and switch to 2nd line due to tolerability and convenience (in this order, imo).
Add continuous generic pressures and I'm not at all convinced that this is a game changer.
Reclast goes generic in the US in about 9 months, so things will be even harder for Prolia and odacatinib.
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