10 Jan 2012 | 16:29 EST | Posted by Rebecca Hersher
With the global market for hepatitis C therapies expected to be worth $20 billion by the end of the decade, drugmakers have been racing to consolidate their hep C pipelines. In November, California’s Gilead bought Pharmasset, a New Jersey-based company with three experimental compounds targeting the hepatitis C virus (HCV), for a whopping $11 billion. And over the weekend, New York’s Bristol-Myers Squibb announced a $2.5 billion deal to acquire Inhibitex, a small Georgia-based company with an HCV polymerase inhibitor called INX-189 in phase 2 development. But, despite the growing interest in HCV therapies—Merck executives went as far as telling Bloomberg News at this week’s JP Morgan Healthcare Conference in San Francisco that the drug giant will “do anything” to be the leader in hepatitis C—some analysts say it’s too soon to know whether the HCV market will be as lucrative as it appears.
“It’s really tough to predict,” says Saurabh Aggarwal, an analyst at Novel Health Strategies in New York. “There is a lot of speculation.”
Predicting the HCV market is complicated by the geography of the virus: an estimated 200 million people worldwide carry HCV, but only around 5% of those infected live in the US and EU—the regions where drugmakers can expect to reap the most profits.
Those figures could still stack up to a potentially enormous untapped market, which helps explain why pharma companies have been willing to pay such premiums to acquire smaller firms with promising HCV therapies. But with two-thirds of HCV-positive individuals in the developed world over the age of 50 and three-quarters of people unaware that they’re even infected, HCV drugs still remain a financial gamble. “Companies are betting on the American market because the pricing is much higher,” says Aggarwal. “But in the US, [HCV is] not like other therapies that have ongoing incidence and prevalence. The window of opportunity is limited.”
That limited time window has pushed drug companies to invest quickly in new HCV treatments. Vertex of Cambridge, Massachusetts and Merck of Whitehouse Station, New Jersey both won regulatory approval last year for the first generation of targeted anti-HCV therapies, but these drugs still don’t work for around a third of all HCV infections that are caused by genotypic subtypes not currently hit by the existing compounds. Allan Haberman, founder of the Biopharmaceutical Consortium in Waverly, Massachusetts, says that the unaddressed subtypes set HCV apart from past investment frenzies around a single therapeutic area. “Everyone jumped on statins,” he points out, “but it turned out there was only room for one blockbuster in the end. Here there is an entirely untapped market in the genotypes that can’t be treated yet.”
Still, the question of whether the drug industry is paying too much for promising HCV acquisitions is still up in the air. Joe DiMasi, director of economic analysis at the Tufts Center for the Study of Drug Development in Boston, says that identifying irrational exuberance in drug investments is a notoriously difficult game.
Aggarwal agrees. “There is an additional challenge in predicting the future sales curve for hepatitis C because there’s a big education aspect to getting asymptomatic people diagnosed,” he says. And as baby boomers age, the clock is ticking for companies that have already poured hopeful billions into HCV.
Image courtesy of James Cavallini/Photo Researchers Inc via Wikimedia Commons
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