Ok, but surely because of the unknowns it is more sensible to look at possible range, both in terms of price and uptake rather than just decide on an arbitrary figure and then declare it insufficient for the company financially over a 3 year term.
In particular, the uptake is very very conservative. If the Japanese government gets behind this measure, then uptake would be more than 10% in the first year, surely?
As for whether the Japanese government might subsidise MSB to more than the market actually sees: Most subsidies are built into the negotiated price with the company, much like our PBS.
But "the market" mostly sees the price to the consumer, I am just clarifying that you are speaking of the negotiated price to the Japanese government, and that will include the relevant subsidy.
As for efficacy - indeed, the product may be successful.
Well, let's be clear that it's been successful so far.
It wasn't (successful) in the last round of Phase 3 studies in the same indication, carried out by Osiris.
So what are the distinguishing features of the Osiris trial then, in terms of similarities and differences?
Otherwise it's not relevant to the MSB trial except to say that MSB must prove efficacy which is a general principle not assisted either way by the Osiris analogy.
Also, was the Osiris trial fast tracking under the Japanese model like the MSB trial is?
A lot of people with refractory GVHD die, meaning that they are, in cold, hard pharmacoeconomic terms, very cheap.
Sorry, I don't see how those two statements automatically follow. The question is surely, do they die quickly, or do they linger?
The other question is how quick their recovery is after treatment with MSB's MPCs, do they recover quickly or do they recover slowly?
Both are relevant questions to any realistic assessment of the costs and benefits of a therapy or treatment.
If you can treat them quickly in terms of the onset and diagnosis of disease, and they rapidly recover then you have a much more cost effective situation using all metrics, including QAL.
There are other final benefits related to the extent of recovery, such as return to productive work.
Everyone wants to save on costs, particularly governments.
(note to the uninitiated: The quality-adjusted life year or quality-adjusted life-year (QALY) is a measure of disease burden, including both the quality and the quantity of life lived. It is used in assessing the value for money of a medical intervention.)
Speculation on Japanese revenue stream, page-6
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