InPharm article on Telaprevir vs Boceprevir in the battle for market share....

Pretty fair-balanced article on Merck vs Vertex in the battle for market share here in the states. The author left out a large disadvantage of both drugs... the propensity for drug interactions. As for the high cost of Telaprevir, one could also make the argument that Vertex needs to make back it's investment in the drug in a hurry... the the first of the second generation of Direct Acting Antivirals with potential for greater efficacy and less side effects are due sometime in 2013, giving Telaprevir and Boceprevir relatively a short window of opportunity.

Hepatitis C rivals go head to head
By amcconag
Created 19/07/2011 - 14:28
Summary:

Launched within days of each other in the US, J&J and Vertex’s Incivek and Merck’s Victrelis will battle for market share


The field of hepatitis C treatment has two new groundbreaking medicines to treat the condition.

Merck’s Victrelis (boceprevir) and Johnson & Johnson/Vertex’s Incivek (telaprevir) were both launched in the US in May, and Victrelis has now been given the green light in Europe.

The drugs have much in common; both are oral protease inhibitors, and promise to significantly improve treatment when added to the current standard treatments for the disease. An estimated 270-300 million people world have the disease.
Both drugs are expected to reach blockbuster status, but which will win out in the battle for market share? Many analysts are predicting Vertex and J&J’s Incivek will prevail because it has shown a higher cure rate, and a simpler and faster simpler dosing regimen.

But Vertex, which has never launched a drug before, will have to overcome the might of Merck and its new US marketing partner Roche.
Victrelis versus Incivek

Current hepatitis C treatments produce only limited success in treating patients with the disease. The current standard treatments are peginterferon alfa and ribavirin taken for 48 weeks, but less than 50% of patients respond to this therapy.
The two new protease inhibitors promise to help more patients, and to lower the viral load of the disease down to an undetectable level, considered a cure for the disease.

Both Incivek and Victrelis are licensed in the US to treat hepatitis C genotype 1 infection with compensated liver disease, including cirrhosis, in combination with peginterferon alfa and ribavirin. The new drugs can be given to patients who have been previously untreated or who have failed previous interferon and ribavirin therapy.

Victrelis had a 66% sustained viralogic response (SVR) - as close to a cure as possible - in late-stage studies, but Incivek produced a significantly higher rate of 79 per cent. Incivek has a further advantage - patients who respond well to the drug can stop treatment at just 24 weeks rather than the nearly year-long 48 weeks of the current drug regimen. Safety data suggests Incivek is generally well-tolerated, but about half of patients developed a skin rash or itching, while a small number developed the severe Stevens-Johnson Syndrome.
Merck’s Victrelis has a few factors in its favour - is likely to cost less (depending on the duration of treatment) and has had no cases of the Stevens-Johnson Syndrome. However Merck’s drug has a more complicated dosing regimen, which is expected to count against it.
The marketing battle

Merck has shown its determination to win the US marketing battle by signing a co-marketing deal with Roche. This means Vertex will have to compete with two of the biggest and most experienced salesforces in the sector. Vertex has a sales team of 115, a fraction of the numbers Merck and Roche will be able to muster. But Vertex’s chief executive Matthew Emmens believes the company can hold its own against its bigger competitors, thanks to the already high level of awareness among their target audience, and the advantages of its drug.

Vertex’s belief in the superiority of its product is reflected in its price, which is $49,200 for a 12-week course. This cost is much higher than Victrelis, and is equivalent to the price of a whole 48 week treatment with Merck’s drug. Vertex justifies the high price on the promise of a shorter treatment period, but patient advocacy groups have already criticised the high costs patients and insurance systems will have to pay.
European approvals

The FDA made a speedy decision on Victrelis and Incivek, fast-tracking the drugs because of their groundbreaking status. The drugs have been given similar priority status in Europe, and Victrelis has just gained final EU approval. Vertex says it hopes for a European approval, where its partner Johnson & Johnson holds the marketing rights, by the end of the year.

Liver experts are already familiar with what Victrelis and Incivek will offer, and are looking further ahead to continued progress. Researchers are now looking to combine molecules or produce a single agent to simplify treatment and do away with interferon, which produces flu-like symptoms and other side effects. There is also a need for drugs to treat a wider spectrum of virus genotypes, and to address viral resistance to drug treatment.