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sts66

02/07/14 12:38 PM

#25138 RE: sts66 #25136

Kept reading, also found this gem - not sure it's good news - yeah, the FDA, the NIH, the AMA etc are all desperate to get the trial results to put the issue to rest once and for all, but AMRN can't afford to keep the original design w/o ANCHOR, which may torpedo getting the desired stat sig data they need:

If ANCHOR indication is not approved, FDA is aware that the continuation of this study in it's current form is subject to change

And this bit:

Development
Approval through FDA (sNDA) or courts to market results of ANCHOR trial

Again, 1st amendment issue to show docs ANCHOR data (and likely JELIS data too), does not mean ANCHOR will be on the label - they'll go for off-label scrips like Lovaza, although that makes it more difficult to get insurance coverage.

All in all, the presentation's tone says that they know they are facing an uphill battle with the FDA that they are very unsure about winning, may even be leaning towards the realization that they're not going to get ANCHOR any time soon, maybe not even until something comes out of R-IT, like great interim results, for instance, but halting enrollment pushes req'd number of stat sig AE's further out.

They're between a rock and a hard place, in limbo because the FDA is entrenched for now - and the FDA has every reason to delay, delay, delay, because without further appeal denials AMRN cannot go to court to seek justice - keeping the matter out of court is the FDA's primary course of action because they know they'll lose. And no political pressure can really help either, the FDA will point to the formal appeal process and claim all avenues must be exhausted first, which is true, whether we like it or not. Hate to say it, but this is dead money for probably at least a year or more unless something breaks the logjam, as in BioBill manages to file some sort of lawsuite that sticks.
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gta888

02/07/14 12:49 PM

#25139 RE: sts66 #25136

Point 4 - they are merely stating the adcom question. Doesnt mean they went or are saying for cv reduction label. This was clarified during adcom in question confusion
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ziploc_1

02/07/14 1:01 PM

#25140 RE: sts66 #25136

"It's now clear, even though they didn't say it, that they tried to get "reduced CVE risk" on the ANCHOR label."______________________________________________________________If this statement is correct, it was most certainly a wrong direction to take and it pissed off the FDA no end. However, it was even more wrong for the FDA to rig the ADCOM and rescind the SPA in an effort to teach Amarin a lesson because, in the process, a large number of Americans were hurt. The FDA could have spoken to JZ beforehand and told him to retract all mention of CV events until REDUCE-IT was finished. It is said that politics is a blood sport and this is a good example.
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nutsyprofessor

02/07/14 2:02 PM

#25142 RE: sts66 #25136

"2. Appears they're saying R-IT may not go forward without getting ANCHOR data on the label - another threat to pull out of the trial."

Although I definitely understand Amarin doing this and I've been saying this for weeks, the act of actually threatening the FDA with this option will not help their cause, for sure.

"4. It's now clear, even though they didn't say it, that they tried to get "reduced CVE risk" on the ANCHOR label. STUPID MOVE."

Dude, this was NOT Amarin's decision, duh, this was the FDA's requirement, not Amarin's. If it had been Amarin's decision they would have simply run PH3 trials to prove lowering of TG's at levels >200 and left it at that. The FDA does not want to approve a Fish Oil product for lowering TG's in the 200-500 range without having proof of some real benefit other than just reducing a bio-marker.

"Lastly, I'm puzzled by pg 18/19 - $4B-$6B market opportunity just for MARINE indication? And $40B for ANCHOR? What are they smoking?!?"

It is obviously a sign of desperation. They need CASH!!!

"Also have this little blurb at the bottom of page 18, which indicates they want to go off label with docs for CVE risk reduction:"

Going off-label is NOT a good idea. The FDA frowns on off-label use big time, although this is a very low risk and the FDA would probably not worry about going after Amarin. However, the act itself shows defiance and this would not bode well with the FDA.

Also, the added statement about lowering CVE's is no different than going to your local grocery store and buying near similar fish oil products at a fraction of the cost of VAscepa. So going off-label doesn't buy Amarin anything in the way of any real revenue.