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Vertex Hep C Drug Still Leads Schering

Adam Feuerstein

Competing hepatitis C drugs from Vertex PharmaceuticalsVRTX and Schering-PloughSGP went "Mano-a-Mano in Milano" this weekend at a European liver disease meeting, and it was really no contest.

Victory Vertex.

Credit Sanford Bernstein biotech analyst Geoffrey Porges for the catchy "mano" line. The subhead of his Sunday night research note wasn't as cheeky, but should resonate just as much with investors Monday:

"Schering-Plough's Boceprevir Still Behind, Still Inferior to Telaprevir."

Telaprevir is Vertex's hepatitis C drug, which had a pretty good weekend at the European Association for the Study of Liver Disease annual meeting in Milan, Italy. On Thursday, telaprevir proved very capable of reducing the viral load of hepatitis C patients who had failed prior treatments. Then in a highly anticipated presentation Saturday, Schering-Plough's boceprevir couldn't match the "cure rate" standard for newly diagnosed hep C patients set earlier by Vertex's telaprevir.

Neither drug is approved yet, of course, and there isn't any real head-to-head data, so don't put any conclusions in ink just yet. With that said, however, the emerging story line from this weekend's meeting is that telaprevir and boceprevir are still No. 1 and No. 2 respectively, but the gap between the two drugs has widened.

Vertex shares closed Friday at $25.72, while Schering-Plough closed at $18.64.

In a phase II study of treatment-naïve hepatitis C patients, Schering's boceprevir achieved a sustained virologic response, or cure rate, after 12 weeks of 57% and 55% in two arms of a multi-arm phase II study that's still underway. Another 12 weeks of observation (for a full 24 weeks) will be required to determine the final cure rate for these patients.

But already, boceprevir has no hope of catching up to telaprevir, which posted final cure rates about 10% higher in its two phase II studies. Those data were presented at a U.S. liver disease meeting last November.

Rates of patient discontinuation and relapse were also relatively high in the boceprevir study presented Saturday, which don't appear to give the drug any discernible edge over the Vertex's telaprevir.

This study is ongoing so there is a lot of data not yet presented, including patients dosed with boceprevir for a longer period and a comparator arm of patients not given boceprevir.

Schering-Plough does plan on moving boceprevir into phase III studies, but with the phase II study still not completed, the company is at least one year behind Vertex, which has already begun its phase III telaprevir studies.

Hepatitis C drug development seems to take twists and turns on a weekly basis, so it's never safe to count any drug in or out. And boceprevir isn't the only competition facing telaprevir. There are promising drugs -- albeit in much earlier stages of development -- from IntermuneITMN, Johnson and JohnsonJNJ, MerckMRK and Boehringer Ingelheim, among others.

With that said, Vertex and its shareholders have to feel good about telaprevir right now.

Bernstein's Porges, by the way, has an outperform rating and a $45 price target on Vertex.