Replies to post #105282 on Biotech Values

[mcbio]

Re: PYMX/PMX-60056

UFH reversal is potentially a big market, so the question here is: To what extent does the superior safety of PMX-60056 warrant a premium price relative to protamine (which is dirt cheap)? Unless PYMX is able to make a convincing economic case that hospitals will save money in the long run by using PMX-60056 instead of protamine, I’m not sure hospitals will readily accept the purely medical justification. Moreover, the squeezing of hospitals’ operating margins under ObamaCare might impede the commercial uptake of PMX-60056.

In addition to safety, I assume there's also the question of whether or not PMX-60056 will turn out to be more effective than protamine. If more effective, presumably hospitals will be more receptive to paying for the more expensive product. Either way, at a ~$73M market cap, the market isn't factoring in much anticipated success at all for PMX-60056. So, any surprise in commmercial uptake of PMX-60056 on the upside (assuming the drug makes it to market of course) would seem to leave plenty of upside for the stock.

[biomaven0]

To what extent does the superior safety of PMX-60056 warrant a premium price relative to protamine (which is dirt cheap)?

There are definitely protamine-related fatalities each year. In this litigious age, it's hard to defend the use of an inferior product that kills people assuming the alternative is not outrageously priced.

Protamine is also harder to use (it has to be accurately titrated) and heparin rebound can be a problem. So convenience too argues for the use of a superior replacement.

Here's a discussion of rebound:
http://jtcs.ctsnetjournals.org/cgi/content/abstract/128/2/211

Lovenox reversal typically would be needed if a surgical procedure is suddenly required - think of a recent hip replacement gone wrong, for example. So seems to me like there would be a market for it. But they should have simply done their trial w/ Lovenox instead of trying to be cute.

[xrymd]

PYMX: I think the two markets—Lovenox reversal and UFH reversal—have to be considered separately.

Lovenox reversal is an impressive scientific achievement; however, I’m not sure the business impetus for such a product is strong because Lovenox, unlike UFH, is not often used in medical settings where reversal is likely to be needed.

UFH reversal is potentially a big market, so the question here is: To what extent does the superior safety of PMX-60056 warrant a premium price relative to protamine (which is dirt cheap)? Unless PYMX is able to make a convincing economic case that hospitals will save money in the long run by using PMX-60056 instead of protamine, I’m not sure hospitals will readily accept the purely medical justification. Moreover, the squeezing of hospitals’ operating margins under ObamaCare might impede the commercial uptake of PMX-60056. Regards, Dew

Dew: I am starting to think that a lovenox reversal agent will garner a moderate amount of sales. I have had to cancel numerous invasive procedures due to the patient being on lovenox. This has led to patients staying in the hospital longer than need be. It seems every patient in the hospital goes on atleast mini dose lovenox for DVT prophyaxis.

UFH I'm not convinced as protamine is so cheap. Unless you give it rapidly the minor complication rate is very small. (Transient drop in blood pressure).