Thursday, November 25, 2010

BusinessWeek's Tom Randall Misses One Third Of CETP Story. No Surprise, There.

As I wrote much earlier, the main stream science media has done a marginal job -- at best -- of going beyond the soundbites very carefully fed them, by Merck, certain Oxford and (to a lesser extent) Harvard researchers, each affiliated with the Anacetrapib DEFINE study.

Continuing that trend overnight, Bloomberg's BusinessWeek has a new piece out, written by Tom Randall, purporting to recite the history between Merck and Pfizer, and the $50 billion battle to lead cholesterol management medicine, over the last 15 years or so.

Randall concludes that Merck may emerge the winner -- despite Pfizer's Lipitor® decade of dominance, now coming to an end -- as it goes generic next year (another fact he, and Bloomberg's BusinessWeek fail to mention, or put in context). Randall reaches this conclusion by citing Merck's perserverance, in continuing on with Anacetrapib -- after Pfizer's lethal study results on Torcetrapib (same class) in 2006. True enough -- that was a visionary and courageous decision -- in so far as it goes. But it is not all of the story -- by any stretch.

Mr. Randall forgets to mention Roche. Roche's Dalcetrapib is two years (at least!) ahead of Merck's CETP candidate. [Not that Roche is a screaming buy here, either though -- see next full paragraph.]

Merck won't be in the US market with Anacetrapib before 2018, in all likelihood.

And, because Lipitor goes generic next year -- some 20 million Americans will have been on cheap, effective generic statins for five years when Roche's Dalcetrapib CETP inhibitor (a thus-far less effective variant on MRK's CETP inhibitor) reaches market in 2014 to 2016. All that assumes no deadly flame out, for either candidate.

Yep, as I earlier mentioned, back in July of 2009, Roche began a 15,600 patient Phase III, multi-center efficacy/CV outcomes study on its CETP inhibitor candidate, called Dalcetrapib. Merck will take the equivalent step, with its CETP candidate, Anacetrapib, on its timeline, sometime in early 2011, in a 30,000 patient trial run by Oxford University, to be called REVEAL.

Thus, Merck is now -- simply stated -- a couple of years behind Roche -- but Merck's Anacetrapib is showing (at least at this stage of the game) considerably better lab results, with its CETP inhibitor candidate. Even so, both Roche and Merck will face a population -- in 2018 -- that has been on statins (at perhaps one-one hundredth the price) for seven to ten years, and is seeing real benefit from that course of therapy.

Net, net: I'd not bet too terribly much on the Tom Randall Bloomberg/BusinessWeek piece.


Marilyn Mann said...

Good points. Personally, I'm not placing any bets on either drug right now.

condor said...

Agreed! Happy (Belated) Thanksgiving, Marilyn!

It is still more than 50 percent likely that both candidates run into additional difficulties on the road to market.