October 1, 2010

Vertex Edges Merck In First Round of Hepatitis C Fight

Oct. 1 2010 - 3:13 pm
By ROBERT LANGRETH

New details of studies of rival hepatitis C drugs from Merck and Vertex Pharmaceuticals were released today in advance of a crucial upcoming meeting of liver specialists at the end of the month in Boston. The drugs, so-called hepatitis C protease inhibitors, represent the first class of agents that directly target the hepatitis C virus. Both have substantially boosted the cure rate in big trials, raising excitement among hepatitis c specialists.

While the drugs haven’t been compared directly, it appears that Vertex’s telaprevir drug is is a nudge better. Unless differences in tolerability and side effects emerge, if both drugs are approved, doctors may look at the data and go with the Vertex drug first because its cure rates appear to be a few percentage points higher.

Here’s what Howard Liang of Leerink Swann wrote in a note today:

“Apples-to-apples” comparison of boceprevir vs. telaprevir in treatment-experienced patients is possible for the first time and appears to favor telaprevir. In prior relapsers, SVR was 69%-75% for boceprevir vs. 83-88% for telaprevir. In what we would call partial responders MRK has a different definition, SVR was 40-52% for boceprevir vs. 54-59% for telaprevir. Cross-trial comparisons are always difficult but we believe the totality and consistency of both treatment-experienced and treatment-naïve data give an impression that telaprevir may be more potent.

If there are significant side effects to the Vertex compound that haven’t emerged yet, it could totally negate Vertex’s apparent advantage. But if Vertex’s drug is perceived by doctors as slightly more effective, who does Merck sell its drug to?

Merck R&D head Peter Kim may have some answers to this question. He is going to the liver meeting where he will face lots of questions from Wall Street types about where Merck’s drug will fit in. He needs to rebut the doubts about his company’s drug.

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