RE:RE:RE:RBC reportAbout this comment : " I imagine it may not be the best sales technique to tell a doctor he has it all wrong but it seems like that may be the case in many situations." At the annual meeting TH clearly said their intention in 2019 is to also go more directly to patient in different ways to "promote" Trogarzo. They certainly realised that doctor's intention to prescribe Trogarzo to their patient is finally different than what the servey said 2 or 3 years back. So I to agree that doctors seems not to trill about prescribing Trogarzo to their patient. TH took almost a year to realise that and they adjust their strategy consequently. About SP, if TH intentionnaly decided long time back not to speak about it and letting the numbers speak by themself, that decision might have been challenged internally lately. Cant imagine anyone on the BOD not bringning that suggestion at some point. If that position was discuss lately, since nothing came out from them, I can see two reasons: 1) TH agree whit SP value as it is now 2) TH are confident that the comming weeks would provide enough good news to increase SP at a more decent value. Of course I hope ... Yes me to I hope, that option 2 is the reason :o)
SPCEO1 wrote: See my comments in red below:
qwerty22 wrote: On trogarzo sales dubuc notes four aspects. "with a focus on 1) increasing the number of patients per physician, 2) educating physicians on the more favorable patient perceptions of an IV product, 3) leveraging strong efficacy/safety data and 4) importance of undetectable viral loads to increase uptake. My question is this the opportunities or challenges, or a bit of both? 1) We expected this, it seems the nature process to occur. By highlighting this is he suggesting its not really happening organically? 2) Well he explains this later, its the physicians that are the stumbling block here, Spceo's idea that doctors would welcome the increased contact and revenue doesnt seem to be accurate. It surprises me its the doctors rather than the patients that are pushing back against IV. It is weird but eveidently accurate - see JFM1330's comments in this regard. I also worry that it may be easier to change the mind of a patient than a doctor about such matters. 3) Not much to say here, this is what they should be doing, maybe doctors are not actually appreciating this. 4) This suggests to me that some of the 'solutions' doctors settled on before trogarzo came to market are still being tried by doctors, such as compromising with persistent low level viremia. I imagine it may not be the best sales technique to tell a docttor he has it all wrong but it seems like that may be the case in many situations. The evidence for using Trogarzo is strong and again, JFM1330 makes a really good case for that. Hopefully, that message can be crafted cleverly enough to allow those doctors now doing the wrong thing to change their mind. Doctors have had years of experience of these options and see it still has some clinical merit. It seems like this is a big part of the challenge. Much of the rest of the comment seems upbeat. When patients take the drug it sounds like on the whole its very successful which is very promising. Getting over the initial hurdle of committing to the drug is the challenge, there is nothing inherently flawed about the drug. On Nash some mixed words as well. I still think label extension based on this trial data is almost an impossibility, "challenging" is still too hopeful a word for me. Very happy to be wrong. I am now thinking that what could happen is they will get some additional language on the label that will allow them to sell it more effectively prior to a full phase III HIV test on exclusively NASH patients. So, not an approval but just some added language onthe label that will be helpfult to he sales effort. Or, maybe the FDA would approve some aspect of NASFLD/NASH right away and ask they do a registry trial (I think that is the right name for it wherein the phase III trial is done after approval. There would seems to be little risk with that approach for the FDA giventhe sfety rpofile of Egrfita) Neither of these are high probability things but there may be more of a chance for something of this sort than you think.The HIV nash future trial sounds like something they are committed to already, which as acomments seems further than they have gone before. While it has been obvious ever since we got the topline results, I do believe it is the first time they have uttered it publically. This would be great if true. It must be true if he said it and it makes total sense. They have no competition in HIV NASH and pricing could be much more attractive there than in the genreal NASH population. The company seemed to have nothing to say about general nash, which the analyst interprets as they wont be going there. It seems too early to make that call, hopefully this is not what dubuc was suggesting, it would be crazy to dismiss it at this moment. I hope the analyst is wrong about this. The Chairwoman spoke openly at the AGM about potentially partnering in the general NASH market, so they clearly are thinking about it. I think one big factor they will need to consider is whether their compeititve position in the general NASH market will be sufficiently good to generate enough revenues at a lower price point to offset the possibility of having to harmonize the HIV NASH price with the lower general NASH price. Or can the two be suffeciently different in terms of dosages or even formulations or some other factor that two different prices can be realistically justified. But I am thinking that TH's marekt position in HIV NASH will be so strong and that the potential number of patietns there be so large that it might not make sense to compete in the general NASH market unless they know they can hold onto the higher HIV NASH price. But if the Grinspoon data is really impressive, it may justify going after the general NASH market too. Overall what he writes makes a lot of sense, Now we just need him to factor HIV NASH into his estimates and raise his rating since his price target is almost twice the current share price. seems the people who put time into analyzing the company on this board are in general alignment with the management on most things, which is re-assuring.