RE:RBC reportSPCEO1 wrote: I have had a quick read of the RBC report. He basically talked to Key Opinion Leaders (KOL's) and used their feedback to come up with a very low expectation of patients for Trogarzo. Interestingly, those long timers here will remember that when the Trogarzo deal was first signed, the expectation was that its sales would amount to about as much as Egrifta's. This was based on TH talking to KOL's as well. Once they did their market research, however, they concluded the market was much larger. Unfortunately, it will take a while and results that don't comport withhis low view of the number of patients.for the analyst to change his forecasts higher.
Basically, it looks to me that he concluded that about 75-80% of the MDR patients are effectively homeless people who will not come in on a regular basis to get an IV. Therefore, that large percentage of the 20-25,000 MDR patients will never recieve treatment. If you are looking for a quck summary of why he comes up with low number of patients, that explains much of it.
Now, the company needs to prove him worng, but that will take some time to accomplish.
I think its fair to say the epidemiology is a real uncertainty here. There is surprisingly little published research on the MDR population so the it makes a lot of sense that RBC go to KOLs for some independant opinion. The fact that they got some quite negative responses from these KOLs shouldnt be ignored. Theratechs own market research is a similar process but in their case they went to 100 physicians, I imagine RBC only spoke to a handful at best. We also got limited feedback from Luc at the last cc that reported they'd now talked to 1000 doctors and their market research holds up At the time I pointed out the importance of that statement because it was at the time a key uncertainty, clearly it still is and maybe more detail on this feedback might be helpful.
One strength of the Theratech market reseach was they actually went to doctors and asked them how many patients on their books they thought could use Trogarzo. In many ways that specifically counters this RBC concern which would appear to be inaccessibility of homeless patients. The market research is specifically looking at the accessible patient population.
The other point I'd make is I've read a fair amount of research reports about the HIV homeless community. They largely revolve around research on how to improve compliance and btw suggested some surprisingly good health outcomes in that population. It shoudnt be imagined that the homeless are totally isolated individuals, there is a significant network (through shelters) that work to connect these people to the health system.
If its true that the RBC number is largely based on this KOL feedback then it looks like potentially a conservative estimate to me. RBC could have recognized that Theratech's own market research specifically addresses this question by talking about the accessible market. Did they do that?
At its worst it seems to give support to an $11 SP going forward and limits downside while we wait for Therach to prove their market research is accurate. The story is still unchanged.