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Just something to think about or discuss I am still of the belief that we cannot fail to be successful. I asked chatGPT the following question. Do any scenarios apply to us.

Question

"Have there been any examples of the best drug for a particular disease failing as a financially successful product"

Answer

Yes, there have been multiple examples where a drug that was considered highly effective for a particular disease failed commercially. This can happen due to pricing, competition, marketing, access issues, or strategic missteps. Here are some notable examples:

1. Dendreon’s Provenge (Sipuleucel-T)

• Disease: Prostate cancer
• Effectiveness: Provenge was the first FDA-approved cancer vaccine (2010) and showed a survival benefit in men with metastatic prostate cancer.
• Why it failed financially:
  • Very high cost (~$93,000 for a full course)
  • Complex logistics (personalized therapy requiring leukapheresis and processing)
  • Slow adoption by physicians
  • Company eventually filed for bankruptcy in 2014 despite medical success.

2. Pfizer’s Exubera

• Disease: Diabetes (inhaled insulin)
• Effectiveness: Worked well as an alternative to injected insulin, especially for needle-phobic patients
• Why it failed financially:
  • Bulky delivery device, impractical for daily use
  • Poor marketing and lack of physician enthusiasm
  • High cost compared to traditional insulin
  • Pulled from the market in 2007, just one year after launch
  • Pfizer took a $2.8 billion write-off

3. Roche’s Viracept (Nelfinavir)

• Disease: HIV/AIDS
• Effectiveness: Once a mainstay in HIV treatment regimens
• Why it lost traction:
  • Contamination scare in 2007 led to recalls and a tarnished image
  • Emergence of newer antiretrovirals with better tolerability and fewer pills
  • Despite being effective, it lost market share quickly

4. Biogen’s Aduhelm (Aducanumab)

• Disease: Alzheimer’s disease
• Effectiveness: First Alzheimer’s drug to target amyloid plaques, but with very mixed evidence of clinical benefit
• Why it flopped financially (so far):
  • Massive backlash over FDA approval process
  • CMS (Medicare) severely limited coverage
  • Very high price ($56,000/year initially)
  • Doctors hesitant to prescribe due to doubts about benefit and MRI monitoring burden
  • Despite being the only approved disease-modifying treatment, sales were extremely poor

5. Zyvox (Linezolid) by Pharmacia/Pfizer

• Disease: Gram-positive bacterial infections (like MRSA)
• Effectiveness: Highly effective oral antibiotic for resistant infections
• Why not a blockbuster:
  • Reserved for hospital use due to cost and to prevent resistance
  • Limited duration of treatment
  • Antibiotics are not usually high earners due to short-term use and stewardship policies

Key Reasons Why Good Drugs Fail Commercially:

• Pricing mismatch with payer willingness
• Logistical challenges or delivery method issues
• Regulatory or perception problems
• Fierce competition or rapid obsolescence
• Poor strategic execution (marketing, education, access)

Let me know if you want case studies specific to a therapeutic area (e.g., oncology, infectious disease, psychiatry).