How do you work out US ARDS annual case numbers?
From what I can tell the yearly moderate/severe ARDS numbers for the US are more like 180k. (source https://www.ncbi.nlm.nih.gov/books/NBK436002/)
The stats are ~70 per 100,000 person years (US estimates range from 64 to 78). Three quarters of these are initially diagnosed as moderate to severe. Of the mild cases one third go on to moderate or severe. So roughly 80% of 70*3240 = 181k.
The mortality across mild, moderate, severe is 27%, 32%, 45% so clearly there is an unmet need and given the daily costs of ICU/ventilation, Remestemcel-L would represent a cost saving if it rapidly leads to safe discharge of a large percentage of patients.
My preferred scenario for Covid-19 would be to negotiate a "one off" payment (note that the US paid $1.6B to Novavax to help them accelerate the development a vaccine), say $US1B, for a "right to use" on all US Covid 19 patients with ARDS, plus a per dosage "at cost" payment allowing MSB to proclaim a "no profit" access for Covid patients and the US to proclaim "no seriously ill American will be denied access to this life-saving therapeutic treatment". In addition, as part of this negotiation, MSB requires FDA approval for Remestemcel-L to be SoC for moderate to severe ARDS in the US.
The cash allows MSB the ability to accelerate trials across multiple areas (I'm keen on arthritis - a classic widespread autoimmune disease) and to rapidly grow manufacture and develop and own 3D manufacture of MSC cells. The move to SoC for ARDS provides a clear large market for the products into the future and MSB comes out of Covid with an excellent reputation for delivering the treatment at cost.
Similar negotiations would be possible with EU and other health systems.
[The above are my opinions and should not be used as investment advice]
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