Victrelis vs Incivek

[frijole]

.S. regulators approved Incivek and Victrelis in May just 10 days apart, which means Vertex and Merck began marketing the competing hepatitis C drugs essentially at the same time. Investors rarely get to watch companies launch two similar drugs simultaneously -- particular two drugs tapping into a multi-billion dollar market like hepatitis C -- so investors are paying close attention to the early prescriptions written for Incivek and Victrelis.

So far, Vertex is beating Merck, which means the marketing battle between Incivek and Victrelis is playing out largely as expected.

For the week ended June 17 (the most current data available), doctors wrote 460 prescriptions for Vertex's Incivek compared to 160 prescriptions written for Merck's Victrelis, according to weekly prescription data compiled by IMS Health. Weekly IMS drug prescription data tracks retail pharmacy, mail order and long-term care distribution channels.

That puts Incivek's market share at 75% compared to Victrelis' 25% with about five weeks of prescription data available. Even before the two drugs launched, investors were expecting Incivek to garner more prescriptions, with some analysts forecasting a 75% market share split for Incivek at peak.

The current consensus 2011 sales forecast for Incivek is $490 million, according to the sell-side analysts who cover Vertex. Buyside investors are expecting more. A survey of 188 investors in early June yielded a 2011 consensus sales estimate of $568 million, including $43 million in the second quarter that ends June 30, according to ISI Group biotech analyst Mark Schoenebaum, who conducted the survey.

Bank of America Merrill Lynch, through IMS, is tracking daily prescriptions of Incivek for those investor clients who are totally obsessed with the launch of the new hepatitis C drugs. Those daily IMS reports, culled from prescriptions reported by retail pharmacies only, also show Incivek topping Victrelis to date.

Doctors are showing a preference for Incivek over Victrelis so far, but that advantage isn't yet translating into a higher Vertex stock price. At Monday's close of $48.73, Vertex is down 15% from May 23, the day Incivek was approved, and down 21% from the stock's 52-week high reached on May 12.

[Third_Time]

I'm being treated though the VA system and all they're offering is Victrelis. I wonder if it has to do with political clout of Merck? Wish I had a choice. I would have chose Incivek.

[Magnum]

Yes, but with Victrelis, My GI said the protocol for Cirrhotics is 4 weeks lead in, then 44 more weeks with added PI's. Oh boy, here I go again..... Arrrrgggghhhh... Why Victrelis? In my case, to avoid the possible and awful rash, and... I never developed Anemia in my last 4 attempts, which is the Victrelis potential major side effect...

Magnum

[pcds]

I discussed both with my doctor.  Because I treated before and responded well to interferon, he didn't think I should go with victrelis. Victrelis uses a 4week lead in with peg and ribavarin before starting the third drug.  The lead in tells your response to the third drug.  Also it was thought the victrelis wasn't strong enough to start out with so it used the lead in to hit the viral load early on.  Both are powerful.  Anemia is a concern which is more severe with victrelis, I had anemia with SOC, needed helper drugs early on.  Had the rbi rash.  The rash with Incivek is very different.

[screaming48]

Good deal Fred, let us know how it goes, Will be thinking of you!

[coeric]

hello Fred,   thanks for your input and the good news about you starting treatment.  i'm sure you are aware of the great success relapsers have with the new drugs.  so please keep us informed.
blessings
eric

[frijole]

Good luck to you, Fred.  Keep posting so we can all see how everyone likes one or the other (or dislikes)

[fredpacc]

Hello all,
My Gastro guy said he definitively prefers the Incivek. I am a relapser and just received all my meds today. I called my Drs NP and she is away for the 4th weekend. They want to see before I start so I am going to have to wait until next Thursday. I don't know if I can wait that long....I just want to get the party started!!!. Best of luck to everyone...may we all clear this curse...Regards - Fred

[coeric]

hi copyman,
does your doc favor one of the two drugs?
eric

[copyman]

I don't think the doctors or patients like the 4 week lead in. Also data showing 28 weeks with vertex drug = cure 75 to 80% of the time.

My hep doc likes to hit the virus with all three drugs and knock it out quickly as possible.

[coeric]

the liver still seems to be compensating. the pathologist saw some bridging fibrosis and some cirrhosis over 19 portal areas. the doc is calling it cirrhosis

the biopsy was transjugular.   a catheter is pushed down the vena cava into the hepatic vein.  the doc removed three cores from the liver.  the beauty of doing it this way is that if you bleed, the blood from the punctures enters the hepatic vein, so it is a little safer than percutaneous biopsy.  also the doc can insert a pressure measurement device into the hepatic vein.  from pressure measurements taken in the hepatic vein, inference of the pressure in the portal vein is then made and described as hepatic vein pressure gradient -hvpg.  mine was high at 11mm so they are having me redo the egd to check for esophageal varices. the hepatologist said that they are seeing folks with bleeds in the varices immediately after successful treatment.  so she wants me to treat any varices before treatment.

one thing i heard on this forum is that light skinned people may be more prone to the dreaded tela rash.  before tx i will definitely request scripts for the industrial strength cortosone cream.

certainly we will learn more about the side effects as more folks start taking these drugs and we exchange our experiences on this forum.  who knows, perhaps some horrible side effects will arise from the incivek that the victrelis users do not experience.  if i had more wiggle room i would wait.  one thing about these drugs is they have very short half lives and are rapidly eliminated from the body.  so hopefully any nasty side effects will be short lived.  
eric

[frijole]

coeric -- what were the biopsy results?  was there anything unexpected?  I thought they usually did not do biopsies on cirrhotics because of the bleeding complications.  In any event, I am glad you are though it.  It sounds like your doctor is saying about what mine is.  He also said the rates were a little better with Incivek and he didn't like the extended period of triple therapy.  I am put off, however, by the possiblity of the rash.  Although I had some riba rash, it was torso -- not such that I could not work.  No one could see it.  This telaprevir rash is another story -- all over.  I have read all of the boceprevir FDA submission (thank you for the link) and am back reading the telaprevir submission.  The boceprevir results for relapsers who responded to original treatment (as I did) are pretty good.  Maybe not quite as good as telaprevir, but still pretty good.  Most people doing the boceprevir seem to be handling it quite well.  The fact that ejoili and candoman reached SVR with boceprevir weighs heavy in its favor for me.  What your doctor said about your maybe being able to clear with only 8 weeks of Incivek is very encouraging.  What is it they say -- everything just leads to more questions, not answers.

kirk - I replied on your thread with the same title.  I still need to look up those links for you.  I think Incivek would suit you well.

frijole

[kirk8]

My Dr. recommended incivek even though I’m treatment nave. She said that she thought it would be slightly more effective in all patients. I read in nave patients effectiveness is about the same but incivek is definitely more effective for relapsers. The down side is more side effects.

[coeric]

i had a biopsy follow up yesterday.  i asked the hepatologist  which drug she preferred in my situation.  she said she had no financial interest in either drug.  but first of all she said the efficacy was a little better with incivek.  she said in my case, with cirrhosis, she prefers incivek because she felt that the shorter duration under triple therapy might be easier.  she did not like the idea of trying to use triple therapy for 44 weeks with cirrhotics.  she said there is not statistical difference between the success rate for 8 weeks with incivek vs 12 weeks. so i could make it to 8 weeks under triple therapy, that might do the job.  i seem to recall there was a pretty dramatic difference with cirrhotics but the difference may have not been significant since so few cirrhotics were in the trials.  i asked about the lack of epo and she really did not think that was that big of problem.  even with dose reduction she felt it was a superior drug.

[willbb]

Interesting ...I am somewhat suprised the spread of 75  -25 % isn"t closer... possibly doctors and /or patients are leaning that way because of the slightly better efficay?

Personally I am hoping to wait for the next set of meds.. if my liver co-operates that is.

Thx   frijole

Will

[frijole]

I don't know if this is going to make it harder for those of us who want to do Victrelis, but Incevik is definitley the one the doctors are preferring to date.  As I had posted earlier, my hepatologist seemed a lot more familiar with Inc than Vic and I think his assumption was that I would treat with Inc.  I don't know if I choose the other, he may not be as comfortable with it.

What is the word in the forum?  What are you leaniing towards (and why) and what are your doctors telling you?

frijole