This is an excellent review of the current state of HCV drugs and the companies developing them. This guy really knows his stuff! After discussing the potential overvaluation of Gilead, the interviewer asked for another company to invest in. The first company that Tucker mentioned was Vertex.
Below is an excerpt from the excellent article on Seeking Alpha with the John Tucker interview. The implication of this excerpt is that an important niche for telaprevir based treatment willl continue to be treatment of patients with cirrhosis and HIV-coinfected patients. The clinical trials using second generation IFN free treatments have largely avoided treating patients in these harder to treat groups (except for Abbot's four drug regimen). Unitll second generation regimens are appproved to treat these sub-populations, the clincial trials supporting TVR+SOC as the best apporved treatment in these hardest to treat patinets with advanced disease will require continued use of Incivek by hepatologists, whose patients cannot afford to wait to see what treatments turns out to be better in the next few years, because their time is running out due to the advanced state of their liver disease.
"The buzz we heard at AASLD was mainly concern that the patients being enrolled in most ongoing clinical trials are not representative of the patients that doctors see in their practices. Companies were presenting 12-week treatment regimens with 90-100% cure rates. We are happy to see that kind of success, but most of the clinical trials exclude hard-to-treat patients. We don't see a lot of trials with interferon-free treatment regimens that include patients with cirrhosis of the liver, which is historically much harder to cure. I've seen estimates that as many as 25% of HCV patients seeking treatment are cirrhotic.
We also don't see trials that include patients who are HIV-coinfected. This is a pretty big group. An estimated 1.2 million people in the U.S. are infected with HIV, and about 30% of them are coinfected with HCV, so about 400,000 HCV patients in the country are coinfected with HIV.
In addition, cure rates with the old interferon/ribavirin treatment regimen were only about 40%, so another 200K or so people in the U.S. are prior treatment failures. We don't see a lot of trials with new treatment regimens that include these patients. One important exception is the Abbott regimen, which included 93% of patients who were previously treated with interferon and ribavirin but failed to achieve a cure.
It could be that 30-40% of patients seeking treatment belong to one of these hard-to-treat groups, and have not been widely included in clinical trials of interferon-free treatment regimens."
so GILD is stacking the deck in their favor. they get the stock price up. they get options and sell and then when the drug hits the market and only has say a 25% cure rate, they say oh well on the way to the bank.