You’re painting with too broad a brush
i would suggest that you are. the road to approval is going to be frought with many failures, so by the time IN-lamdba is approved there won't be that many oral alternatives for class substitution, and those that are available may or may not ahve cross-resistance. As for SEs, the first protease and first polymerase have already failed. the second protease has a high droout rate due to its SE profile. the second polymerase required dose reduction due to severe neutropenia. sure pharmasset's polymerase seems fairly clean so far, but i have a feeling even with all the direct antivirals in testing, there will tons of failures, and plenty of drug drug interactions - particularly among polymerases and ribavirin which share overlapping binding sites. we don't even know if ribavirin has efficacy without interferon. and if you subscribe to the notion (as many expert do) that one cannot do without ribavirin in the treatment regimen, then you contradict yourself because its direct antiviral activity is weak and its primary MOA is felt to be immune-related
jsut like HIV, novel MOA drugs find a niche. INF may remain first liinen for all we know. or it may jsut remain first line for difficult to treat pts (high baseline VL, liver fibrosis, etc.). or it may be relegated to second line. but my point is that interferon will have a place commercially in the HCV landscape, and any place in such a large indcation, especially if you are the INF of choice, is a valuable product. no need to belabor this disussion - pharma will speak soon enough on the value of IN lambda based on the type (if any) partnership the drug commands
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