This is something I've been pondering, how does Acadia get the most value out of trofinetide before using 2591 to treat Retts and Fragile X?
If Acadia doesnt buy Neuren, they won't be the first to bring 2591 to market in my belief. I would probably wait until someone, be it Neuren or a BP who took over Neuren, to bring 2591 to market first and then start the ball rolling on getting approval for Retts. Label expansion is easier when the drug is already approved, Acadia doesnt have to spend as much developing 2591 for Retts. And they can continue with Daybue until that time comes.
To throw money at 2591 in order for it to get approved as soon as possible for Retts doesnt make much business sense to me. Acadia spent a LOT of money bringing Daybue to market, plus I figure 2591 approval is still 3 years away so that eats up some of the market exclusivity for Daybue.
Say 5-6 years from now an eventual approval for Retts 2591 occurs which would be 6-7 years passed since Daybue was approved, essentially nearing the end of market exclusivity for Daybue. Then switch over to 2591 which would still have 4-5 years market exclusivity left to go. Once they switch over to 2591, this could see a significant revenue boost as continuation rates climb.
Alternatively, Fragile X could be the Acadia indication that gets treated first with 2591, the circumstances of which possibly bearing some semblance to the above scenario I described. Fragile X becomes a second indication approved for 2591 after Neuren/BP secure approval first. Then some time later Retts patients migrate to 2591 per label expansion.
Anyway just some musings about what Acadia might do.
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