Ann: Breakthrough Zantrene Heart Protection Discovery, page-101

I originally posted this in the wrong thread so have copied it over here.

Something else I've had some time to think about, and it is also highlighted in the answer to one of the questions in the youtube video. A significantly valuable result of this study is that Zantrene has been shown to work in synergy with the anthracyclines and not as a replacement. When new drugs are brought to market, behavioural change among clinicians is exceedingly hard and is a very time consuming process. I can't speak to how oncology treatment guidelines are written in the US however, here in Australia there are very stringent protocols which are followed to the letter for each and every cancer type, and even subtype.

Commercialising a new treatment, and developing a team of medical science liaisons whose job it is is to form relationships with key opinion leaders and protocol authors, with the aim of embedding your new treatment into a protocol is a time consuming and very costly exercise. Convincing these key stakeholders that your treatment is worthy of replacing an existing protocol is very difficult to do even with great data to substantiate your claims. Making a positive, lasting change in prescribing behaviour is very difficult, particularly among oncologists who generally practice defensive medicine (this is even more pronounced when dealing with the anthracyclines given their cardiotoxic properties.) Long story short, developing a replacement therapy, especially in oncology is very very hard.

Developing an adjuvant or concomittant synergistic therapy on the other hand, whilst still very difficult, is easier in comparison. Prescribers are still able to use the therapies they have clinical experience with, and are comfortable with to a certain extent. At the same time, employing the latest medicine ensuring their patients have the best chance of survival. So if I am a BP looking toward Zantrene as the next major acquisition to boost a pipeline, knowing that I don't have to complete the difficult task of rolling out a replacement to current anthracyclines, and instead I only have to roll out an addition, the value proposition becomes a lot more attractive.

The next major insight I gleaned from this video is the opportunity to co-formulate Zantrene with an existing anthracycline. Again, picturing myself as someone in BP, knowing that I am sitting on an anthracycline that already generates $1bn USD in revenue every year. I also know that its uptake amongst prescribers is suboptimal because of concerns around cardiotoxicity. Imagine the thought of being able to both secure ongoing revenue from an existing billion dollar drug, at the same time as increasing uptake by removing the possibility of treatment-limiting cardiotoxicity. That is immense value. Now whilst this is going on, competing pharma companies with their own anthracycline are now faced with the very real possibility that, whichever company secures the purchase of Zantrene secures the bulk of the multibillion dollar anthracycline market, leaving them with crumbs. Because what oncologist is going to knowingly give patients an anthracycline that could cause cardiotoxicity when there is a readily available solution. The thought of a couple of colossal mutil-national big pharma companies fighting it out over Zantrene is making me salivate all over my keyboard.