ACHN: I think a big point is in what context we should take "therapeutic index" as this is what ACHN and GILD disagreed on with respect to ACH-1095. Is this simply a matter of GILD believing that they wouldn't be able to dose ACH-1095 once daily so they want to use a backup compound that will guarantee once-daily dosing? Or is it a safety concern?
Almost certainly the latter: a safety concern. Once-daily dosing is not a significant benefit in HCV (as it is in HIV) as long as ribavirin, a BID drug, is part of the cocktail.
We just need much more specific information to determine the fate of the NS4A program.
Pending additional information, I think it’s reasonable for investors to ascribe zero value to the NS4A collaboration.
The near-term focus now is going to be on ACH-1625, the protease inhibitor. Although the compound is clearly far behind the leading PIs in the clinic such as telaprevir, the potential for ACH-1625 to improve upon those compounds with once daily dosing and possibly better safety attributes leaves upside potential still for the shares given a $40 million market cap…
The issues of consequence for ACH-1625 are safety, tolerability, resistance profile, and possible synergy with polymerase inhibitors; as mentioned in the discussion above, once-daily dosing is not a significant advantage in the HCV market.