The CF33, Vaxinia and Oncarlytics Deal, page-320

In response to Mason..

This is assuming that CF33 etc.. is in fact a 'me too' drug.I've worked for Big Pharma most of my professional life, and have been a part of many drug launches. Both new in class and 'me too'. Being first in class doesn't necessarily work out the way that you state.

Here are a few examples..

Gliptin class of hypoglycaemic drugs in order of launch: 1. - Sitagliptin (Merck), 2. Vildagliptin (Novartis), 3. Saxagliptin (AZ), 4. Linagliptin (Lily), 5. Alogliptin (Takeda).

Sitagliptin is/was the market dominator. Not so much because there was anything special about it. Just that Merck did an amazing job marketing. Vildagliptin was a total flop, as was Saxagliptin. No real effort was put into marketing of these products. Linagliptin however was a huge success. Bigger than Sitagliptin in some markets due to a slight improvement in renal safety. Marketing again was the key to success. As gliptins are almost identical regardless of manufacturer. Alogliptin was simply too late to the party. It did nothing.

Then we have the GLP1a class of medication. Similar MOA to the gliptins. Just improved efficacy but more severe adverse events.

In order of launch: 1. - Exenetide BD (AZ), 2.- Liraglutide (NovoNordisk), 3. - Exenetide QW (AZ), 4. - Dulaglutide QW (Lily), 5. - Semaglutide QW (NovoNordisk).

Exenatide had a small market share until competition started on market. Marketing is where it's at in Big Pharma. This class of drug was only really used by Endocrinologists until NovoNordisk did some fru-fru weight loss studies to get the TGA to approve use for weight loss (Liraglutide). Sales were stagnating due to the huge price Novo had attached. Since then they have owned the space with their drug Ozempic. They can't keep up with demand. These medications were originally designed to treat T2DM. But now diabetics struggle to get their hands on them as overweight individuals are purchasing off-label in the hope it will assist them dropping 5-10% of their TBM. All due to clever marketing. All these medications perform the same essentially. Results will vary from individual to individual.

Last we have the SGLT2i class. Brand new medication class to assist Tx of T2DM patients. Novel MOA.

In order of launch: 1. - Canagliflozin (J&J), 2. - Dapaglifozin - (AZ), 3. - Empagliflozin (BI/Lily)

Cana was a huge flop. Never got off the ground here in Australia. Nothing wrong with the drug. J&J just couldn't be arsed pricing competitively, so they eventually couldn't compete and pulled out (still used in the US however). Dapa was pretty much released at the same time as Cana, and AZ threw the kitchen sink at marketing. However they took the high road in their strategy, and it didn't really pay off the way they expected. The marketing team at BI/lily were much more savvy. Even though they were much later to market, they took a different take on their strategy and it paid off. AZ was left playing catch up as Empa dominated the market. It still does.

The truth is that for a drug to be successful, it needs many things in order to be a commercial success. Safety and efficacy are just one thing. But the marketing is where the magic happens.