Forbes article - "The Hepatitis C Wars: What Docs Say About The Newest Meds"

(Forbes article by Ed Silverman on the 'DAA Wars' and how HCV providers view Invicek vs Victrelis. Interesting insight, but the most compelling aspect to this is whether the reconfigured Rx data from IMS for the last two weeks of September will confirm a stall in the growth of both products)

The Hepatitis C Wars: What Docs Say About The Newest Meds

By Ed Silverman

Over the past several days, there has been a great deal of confusion about the extent to which physicians are embracing the new Incivek hepatitis C drug that is sold by Vertex Pharmaceuticals. The reason is that IMS Health, the market research firm that tracks prescriptions, has to restate mail-order activity for the drug for the last two weeks of September.

The uncertainty sent Vertex stock gyrating because the initial data suggested prescriptions had stopped growing. Investors are now waiting for IMS to release an update. Meanwhile, we thought it might be interesting to provide a different sort of look at how Incivek is faring along with its equally new rival, Victrelis, which is sold by Merck and Roche.

A survey conducted in August of 80 physicians – 29 gastroenterologists, 25 hepatologists, and 26 infectious disease specialists – finds that Incivek is edging out Victrelis in various ways, according to Decision Resources, which queried the doctors. The latest survey, by the way, was run three months after the meds launched and updates an earlier effort that was conducted one month after launch.

The survey found that a widening gap in physician satisfaction between the two treatments. One month after launch, 36 percent of the docs were satisfied with Victrelis and this rose to 48 percent after three months. Among those physicians prescribing Incivek, 40 percent were satisfied one month after product launch and this jumped to 55 percent after the three-month mark.

Interestingly, the average number of patients being treated was slightly lower three months after launch, although the percent of docs using both meds increased significantly. Both drugs have high recognition – 36 percent of the docs were able to cite either the brand or generic name for Victrelis; the figure was 34 percent for Incivek. And two-thirds reported receiving patient requests for the drugs.

Meanwhile, more than two thirds of the docs have begun using either med, compared with more than one half of physicians at one month after the launches. However, Decision Resources notes that most docs have prescribed both brands, suggesting they are still experimenting. So far, 29 percent say it it too soon to know whether they are satisfied with Incivek; the number was 27 percent for Victrelis.

Another nugget: most Americans with hepatitis C have genotype 1, which is the hardest to treat. The survey found that infectious disease specialists have more genotype 1 patients undergoing active treatment compared to two months earlier; Victrelis share among hepatologists is higher compared to gastroenterologists; and gastroenterologists view shorter duration of treatment and managed care access as significantly more important when choosing a drug compared to the other specialties.

Overall, the main benefit of this new class of hepatitis C treatments is the improvement in sustained viral load or SVR, according to the docs surveyed. While Incivek beat Victrelis on higher SVR, shorter duration and simpler protocol, the perception of superior efficacy was countered by concerns with rash, according to Decision Resources. “While it’s too soon to tell, Victrelis may fill a niche for patients who prefer it’s side effect profile,” the firm reports.