<I must admit to a little concern whether Biogen Idec's own detailing does not emphasize the combination of Avonex and Tysabri as much stronger than Tysabri alone.>
Where did you get the idea that Ty + AV is "much stronger than Tysabri alone"? The combo trial established that combo is more effective by about 54 % than Avonex plus placebo. It was not designed to compare combo to Ty plus placebo.
I have not looked up the Avonex one year relaps reduction percentage, but it's been widely reported here that the TY reduction of 66% is about double the rate of reduction of other MS drugs at one year. So, let's assume the Avonex reduction rate was 33%. TY plus AV was 54% better than AV plus placebo. Let's assume no placebo effect (a bad assumption). 154% of 33% is 51%, which is less than 66% reduction with TY as monotherapy. I suspect the preceding reasoning is not clinically valid, but the thing that prompted this post is the statement that combo is more effective that TY alone.
My point was that, de facto, a number of prescribing neurologists do have this opinion that Tysabri is more effective in "younger" relapsing-remitting MS patients (leaving aside non-RR market for the moment). It may be medically justified in their opinions. (Read the quoted passages from the SG Cowen launch call and form your own opinion.) These doctors' opinions may or may not have been slightly infuenced by the discussions of medical experts close to Biogen Idec and indeed the other present market leaders who have their share to protect. I just wanted to raise it as a concern, no matter what Jim Mullen may say publically. Biogen Idec are hard-nosed marketers with an eye on the bottom line. Frankly, although I realize that 90% of the reimbursement issues will be worked out over time, I am disappointed if it is the case that only 1/10 of those prescibed have been infused up to now. What bothers me about this is the consistent reports that doctors and patients are able to get the reimbursement sorted out when they go speak directly with the insurers. By the end of January, Biogen Idec should have been on top of this with more, even temporary help so that the ratio of prescribed to infused would now be higher. Nevertheless, if they announce a number like 14,000 or 16,000 prescriptions already, that should have a very positive impact on market sentiment. John, can you point to the posts where the 16,000 number was mentioned? Thanks.