Sapan Gai, CCO at Sovereign Metals, discusses their superior graphite test results. Watch the video here.
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I am reliably infirmed generic dox = $1/mg (comes in various vial sizes based on 2mg/ml).
Restating my previous point. Looking at the figures, therapeutic sales in oncology are likely to be around $250B by 2024, (12% CAGR). With an expansion to the market due to "longer treatment cycles and wider patient eligibility", I would certainly agree to the market being closer to the $300B+ mark. Also interesting are the recent oncology acquisitions are in the billions; Array BioPharma ($11B), Five Prime ($1.9B), Grail ($8B), NBE (1.4B) and Immunomedics($21). Partnerships are also rife with Daiichi Sankyo and IDEAYA as good examples with a $3B collaboration for Genmab.
Positive pK data and this could be huge. My view would be £25 per share from here. With the AVA6000 trial going well, the HUA already applied for and APAC ready to go soon, we will certainly have a positive future ahead.
Pro-chemos would certainly be hitting at 5x or more the current accumulative dose. As long as the pK data from the trial goes as expected, I believe that this will be a very big positive.
(Griffith's definitely from the right part of the world and fantastic work through his career. Agree, there were many brave men on both sides)
Most experts providing market size will have taken the NICE and ICER into account, usually provides some base calculations. Thankfully there are experts out there who have done the hard work and provided the price of $250B on the market. Successful clinical results for preCISION would put the price in the multiples of the current chemotherapy market size.
The NHS will have contracts in place for most of the generic drugs and prices are usually significantly cheaper than those listed in the BNF. Contract prices will also differ between England, Scotland and Wales.
worth remembering these are list prices, not negotiated prices. Saying that, dox is off patent so I am not too sure actually
https://bnf.nice.org.uk/medicinal-forms/doxorubicin-hydrochloride.html
but this is a fraction of the overall cost of care
Ophidian
Hi Marik,
Unfortunately I don't. Can't imagine it being too much, the liposomal formulation is probably considerably more expensive though.
@aj, do you know the cost of dox per patient at the moment, with a given number of cycles?
@Ophidian. Agreed- I just hope its the company I work for, or I may have to consider getting a job at avacta, depending on the data ;)
Its not that I don't want to.answer your question its more that I'm not sure how it relates - do you want total HC for UK, phatma Bridget, oncology or an individual drug. Without outcome data cf CSC its not possible. What is possible is to say that budgets are not quite as expandable as we would like.
Kenneth Griffith was from the right part of the world. Brave men on both sides.
@aj242 - pretty sure that won't be Avacta's problem anyway they will simple take a royalty and other bigger fish will negotiate on bulk with a portfolio of drugs.
Ophidian
Rorkes, don't worry about it, I'll go with aj's reply.
I agree Ophidian, the potential is there, the question is, what price will it be retail, what will the discounted price be, and how many cycles will NICE allow before adding a cap. A lot will depend on the tail of that curve too.
Can I just check - you think healthcare budgets are unlimited?
ORP. The inputs will be radically different - as you say its not just efficacy - tolerance, drop out rates, post treatment complications etc. However, the HE models would stay the same - you will be aware the HE data is becoming an increasingly more important part of the clinical trial program. However, even with all that pricing is not open ended and the DoH has become very good at saying sorry you are very good but too expensive. Come back when you either have even better outcomes or a lower price.
If there's any evidence that AVA6000 is successful, you're going to have several major pharmas stepping in with offers.
Certainly from what AS said and the fact the first patient has had multiple doses and they continue to extend the trials, it tells me that it's working exactly how they hoped it would.
Thanks aj, we can have physicians consultation chat another time ;0)
Rorkes I understand that you don't want to answer the question, don't worry if you don't know. I was interested.
Just to lighten the mood, did you know that Kenneth Griffith wrote the screenplay for Rorke's Drift?
agree- I think what will be very interesting is the how avacta will price their molecules and where they drop the price in discussions and how much of a knock on effect this will have on their other indications. Its all very exciting for people like me to sit here and think about lol
if we use a 50% escalation and go four successful cohorts - the the MTD will be 300% of the current lifetime allowance for Doxorubicin. This could mean patients could get 20+ rounds of Chemo - that's every three weeks for over a year ! Even just dosing it would need some rethinking
Ophidian
AJ you make some good points - I didn't go down the ICER route cause it ends up ending in same place. From what you have written I'm guessing you have some familiarity with the pricing negotiations with DoH, the role of NICE and the reimbursement mechanisms that were introduced I think in 2014 to control NHS Rx budgets.
These all demonstrate that whilst a company may wish to charge x for a drug the PAYERS push back - I suspect the ICER foot ava006 will enable more to be charged for a total course of treatment - how much will depend on the health benefit. If there is a cap then that is one approach but there are others. What won't be the case and really never has been is you can produce an amazing product, save lives and charge as much as you like.
I think it is true to say that the health economics of Chemotherapy would be turned on their head if AVA6000 hits the market. Chemo is seldom given in isolation and treating the impact of chemo is as much a part of the healthcare as the chemo itself. A whole new cost benefit equation will be required.
Ophidian
fair enough Marik, will leave it between you guys.
Thanks aj, I agree with your points, but instead of provisionally taking this as purely med/pharm NICE and ICER equation, I'd like to find out what the health economics that Rorkes has researched.
As well as answering that, can you answer my initial question, what is the cap?
without this BB turning into a cesspit again, in regards to health economics, NICE usually require the ICER to be less than £50k for indications that meet "end of life criteria" which will be a lot of the indications which avacta will apply for a license for (dependant on what is SOC at the time and what our efficacy data is). If the indication doesn't meet end of life criteria, the ICER is lowered to £30k. These ICER's are not easy to reach, countless modelling needs to occur to extrapolate the OS and PFS data. There are many unasnwered questions, will there be a 2 year stopping rule? can you be rechallenged with IO's in the 2L setting, how much uncertainty is there around the endpoints? could we apply for a PIM and then EAMS to create some RWE?
As I said, lets stay grounded, we are worrying about things 5 years down the line here.