Replies to post #71781 on Biotech Values

[dewophile]

interferon and HCV

there are small molecule drugs in development that aim to increase endogenous interferon, so a hypothetical soc all oral cocktail may in fact include an interferon component

in general though i agree w your premise - interferon can always add something to efficacy, but whether or not direct acting all oral cocktails will have sufficient success to not warrant the SEs associated with interferon remains to be seen. fwiw i think the statement "virtually everyone in the field thinks this will happen in due course" may include some who counted on INF-boosting oral agents and/or never imagined an effective INF with a very clean SE profile would ever come to pass

PS: in my reading i came across an interesting tidbit. if you give interferon during the acute phase of infection (as monotherapy) there is a >90% cure rate even for genotype 1 (and is largely felt to be why 50% of pts exposed do not become chronic carriers)

[DewDiligence]

Re: IFN use in HCV

We need to distinguish between a scientific answer to your questions and a business answer. From a scientific standpoint, it’s possible that adding interferon of some variety to an HCV cocktail will always generate some incremental benefit. From a business standpoint, however, the question is: How big is the increment?

Josh Boger has talked about the latter question at some length. Boger thinks the upper limit of SVR from a business standpoint is about 85% (on an ITT basis); i.e., attempts to push the SVR rate even higher would run into the Law of Diminishing Returns.

If you agree with Boger (as I do), then the business question one should be asking is not whether non-ifn cocktails will be able to benefit from adding ifn; rather, the question is whether (and when) non-ifn cocktails can reach the 85% SVR threshold.