Deaths in the US during 2009 from lower respiratory diseases -
50,774 - Pneumonia (J12–J18)
J12 Viral pneumonia, not elsewhere classified
J13 Pneumonia due to Streptococcus pneumoniae
J14 Pneumonia due to Hemophilus influenzae
J15 Bacterial pneumonia, not elsewhere classified
J16 Pneumonia due to other infectious organisms, not elsewhere classified
J17 Pneumonia in diseases classified elsewhere
J18 Pneumonia, unspecified organism
122,448 - Bronchiectasis and other chronic lower respiratory diseases, excluding cystic fibrosis, bronchitis, bronchiolitis, emphysema and asthma
I'm not clear on the meaning of the Bronchiectasis number. From what I've read, it's difficult to see how a patient could die of Bronchiectasis without pneumonia being the final stage. I would have expected those numbers to have been captured by J17. Any informed thoughts please?
If memory serves, the US patients who received iPlex under the ALS EAP were supplied the drug free of charge by Insmed. In Italy the health service footed the bill for their patients. Patients elsewhere (supplied via IDIS) were required to pay.
Insmed could afford to be generous with those US ALS patients. From memory only twelve patients were involved, Insmed was no longer incurring manufacturing costs, and there was no open-ended commitment (due to the finite remaining supply of iPlex).
I suspect from those annual mortality numbers above that the demand for Arikace will be on a scale where the Company will have no choice but to at least cover its ongoing manufacturing costs.
I'm not claiming that Arikace therapy would prolong the lives of 173,222 US patients each year. But my gut feeling is that many of these people are dying from pulmonary bacterial infections Arikace could control.