Pillar 1 - FTO (new thread), page-2813

I agree and I think it’s always good to have a sense of urgency because most of the time, being FIC or First Mover can have lots of advantages over BIC as demonstrated in the book, For Blood and Money, Billionaires, Biotech and the Quest for a Block Buster Drug.

In the book, Pharmacyclics had their drug, Imbruvica, the first BTK inhibitor, approved first by the FDA through the accelerated approval process for the use in mantel cell lymphoma in July 2014. Just over 3 years ahead of their competitor Acerta’s BTK inhibitor, Calquence, which was approved for rare blood cancer in Oct 2017.

Pharmacyclics got bought out first, of course, and was also on the market first.

By 2019, Imbruvica had 11 approvals and US$5.7B in sales vs. Calquence’s $164M. In 2020, Calquence recorded $511M vs. Imbruvica’s $6.6B and predicted to be $10B by 2024 and 5^th largest drug in the world. What an only 3-year lead can do to sales !

Calquence has proven that it is a better selective BTK inhibitor with less detrimental side effects than Imbruvica’s but its FIC/First Mover Advantages made it King of BTK inhibitor in sales.

Hopefully bisantrene will be the First Mover of both FTO inhibition and CPAC. Add BIC to bisantrene and we will have a Blockbuster drug.

Great book For Blood and Money and how uncanny similar it is to Race. I hope to find some time and put together my views soon and share that.