Just got round to listening to the call and indeed it was a very good one and they seem prepared and with clear strategic direction.
At 2.5 million H.pylori treated patients per year in the US alone and with their data, then at a mid-rage 30% penetration we are talking sales of 488 Million dollars. Tag on Japan, that has a search and treat focus regarding H.Pylori and stomach cancer, and then EU, then China with a very high anti-biotic resistance issue and this definitely looks like it could comfortably reach blockbuster status.
Talicia price at $650 seems on the higher range vs the branded alternatives, but not by a large proportion.
Omeclamox-Pak® (omeprazole + clarithromycin + amoxicillin) costs $585, but 105 recreated on generic
PrevPac® (lansoprazole + clarithromycin + amoxicillin) costs approximately $800, but 150 recreated on generic
Pylera® (omeprazole + bismuth subcitrate potassium + metronidazole + tetracycline) costs a similar $625
Also I remember from the analyst presentation they did before that about 90-95% of prescription is generic recreated and 5-10% Branded.
But again that is mainly because the individual parts of the above branded combination pills are available individually at the doses needed.
Not only is the key ingredient of Talicia (rifabutin) not available at the same doses generically, essentially blocking generic recreation, but the eradication rate of 90% vs 60% is a no brainer and that the guidelines state that if you treat and fail you'll have a harder time treating with something new later, so better to get it done first time.
If we could also expect the physicians to keep in mind that most people have already been on clarithromycin and metronidazole therapy for something in the past, then rifabutin based Talicia would be a pretty clear go to 1st choice as well.
And that ok it might be more expensive than the alternatives via generic recreation, but you at least know you have a 90% chance that the patient doesn't have to pay for more drug after prior failed therapy, so the price differential becomes less for the benefit.
A nice benefit as they have mentioned is that no-one else is promoting on this indication which means hopefully relatively easy conversion to prescription.
This said I think it should be easy for them to take 10% of the market, then more effort to get to 20 then 30%. Hopefully they can maximise on their QIDP and patent.
Aemcolo potential less clear, and I feel priced at $157 seems a little high. The main benefit I really see on this is from the Physician side with a pro-active desire to reduce total microbiome exposure and side-effects. The faster treatment window is statistically very significant, but I wonder if very meaningful clinically or for most patients given the cheaper price of alternatives. Will just have to see.
Seems like a good job so far though!
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