IRX 211 OPIOID ALTERNATIVE, page-6

From the attached South Korean study on the cost effectiveness of Rapid Onset Opioids (ROO), we see a snapshot of the market share split.

According to IQIVIA ROO market data:

• SLF (disintegrating tablet under the tongue) 57%
• FBT (disintegrating tablet above a rear molar) 29%
• OTFC (moved around the mouth using the citrate-containing sugar matrix) 8%
• INFS (nasal spray) 6%

Two overseas studies on drug selection were referred to.

In the first study, which assessed ease of administration, palatability and overall impression with regard to only SLF, FBT and INFS, the most preferred drugs were SLF, INFS, and FBT. SLF had 20 positive feedbacks relating to the convenience, while FBT had 18 negative feedbacks.

The second study compared seven ROOs using the system of objectified judgment analysis (SOJA), an objective evaluation and analysis system for rational drug selection. Among the 7 assessment items, for ease of use, the highest scores were in the order of SLF, FBT, and OTFC.

SLF was evaluated as the best overall in terms of rapid onset of action, ease of administration, and drug cost and also had the highest market share. However, the longer the breakthrough cancer pain duration, the more cost-effective the other rapid onset opioids.

It is clear SLF is the most popular ROO and being the easiest to use is a big factor for its 57% market share.

Where would IRX 211 fit into this picture if at all?

As far as ease of administration, it feels it would be a mile ahead. Pain medicine delivered by an asthma inhaler is clean, fast and easy compared to dissolving a tablet under your tongue for around one minute until completely dissolved without chewing, sucking, or swallowing.

Also, as mentioned in a previous post there may be a market for patients who have a personal preference to be less dependent on opioids when it comes to treating their breakthrough pain.

These two factors form 2 pillars of an attractive alternative to ROOs but of course it all depends on if the board follows the FDA’s feedback and, in turn, how fast and effective IRX 211 works and at what price?

Imho & Gltah

Comparison of Fentanyl-Based Rapid Onset Opioids for the Relief of Breakthrough Cancer Pain: Drug Price Based on Effect Size (ekjcp.org)