NEW YORK ( TheStreet) -- While you watched NFL football Sunday, I was hanging out at the American Association for the Study of Liver Disease annual meeting in downtown Boston. After the meeting, I drank some beer with buyside investors, many of whom were emerging from all-day consulting meetings with liver disease doctors.
Here's a quick sketch of the Wall Street gossip mill emerging from the "Liver Meeting":
Doctors are being conservative with Harvoni treatment, preferring 12 weeks over eight weeks. Giving another four weeks of Harvoni is no big deal, so why risk treating a patient with a shorter course of the drug only to have them fail?
There are a lot of hepatitis C patients to treat. Doctors don't see treatment demand diminishing any time soon. (Interpretation: There's a long tail to the hepatitis C market.)
Some doctors are holding back prescribing Harvoni until Abbvie's (ABBV) - Get Report all-oral regimen is approved and the reimbursement landscape becomes clearer. Most hepatitis C patients can afford to wait an extra month or two for treatment, so waiting is no big deal. These doctors aren't saying they prefer the Abbvie regimen over Gilead's Harvoni, necessarily; more that they want to see how insurance companies behave when two competing regimens are available. (Interpretation: Gilead's fourth-quarter might be soft.)
Abbvie isn't expected to discount the list price of its all-oral hepatitis C regimen by a significant amount compared to Gilead's Harvoni. But Abbvie will attempt to negotiate discounts with payers and Medicaid privately.
Insurance companies are pushing back on reimbursements for earlier-stage hepatitis C patients. Patients with more advanced fibrosis, i.e. F3 and F4, are being cleared for reimbursement first.
Merck (MRK) - Get Report will continue to push for a more effective triple combination therapy in the wake of disappointing results from the C-Swift study. (For the record, Merck insists C-Swift was not a disappointment.) The next regimen will consist of the protease inhibitor grazoprevir, the new, pan-genotypic NS5A inhibitor MK-8408 and MK-3682, the "nuc" brought into the company via the Idenix Pharma acquisition. Merck will start a new phase II study with this "optimized" combination early next year, and hopes to have results ready for presentation at next year's Liver Meeting.
Regulus Therapeutics (RGLS) - Get Report is not winning many converts among hepatitis C doctors. An injectable treatment option is too little too late in an era of convenient pills, doctors say. RA Capital's representative asked every doctor at the meetings if a single injection cure for hepatitis C would be an attractive option -- an unrealistic hypothetical, but an understandable question coming from RA Capital given the hedge fund bought a huge chunk of Regulus' recent financing.
Genfit (GNFTF) will be announcing results from the phase IIb study of GFT505 in NASH at the "end" of March 2015, company executives said at their investor meeting Sunday night.
Adam Feuerstein writes regularly for TheStreet. In keeping with company editorial policy, he doesn't own or short individual stocks, although he owns stock in TheStreet. He also doesn't invest in hedge funds or other private investment partnerships. Feuerstein appreciates your feedback;
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