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Insmed Incorporated Message Board

  • blehair Jun 18, 2013 3:46 AM Flag

    NTM indication already worth $8, and will be worth $20 by year's end if P2 succeeds.

    As for how much the market may be attributing NTM to the current PPS? I don't know, but there really is only upside regardless of the upcoming P3 results. The reason why it could be worth $20 by year's end is because if the P2 data is good enough, it may be sufficient for an NDA given the orphan status of the drug in this indication.

    Secondly, the chances that the P3 results do not show superiority are slim. Why? Because the enrollment exclusion criteria does not forbid historical use of TOBI. It does forbid its use up to 8 wks prior to enrollment into the P3, but the resistance will still be lingering amongst those TOBI users. In comparison, Cayston's criteria forbid TOBI use for just 4 wks prior to enrollment, and look what the results were, TOBI didn't even have 1% FEV1 improvement after 28 days.

    Another thing to consider is that in the Cayston vs TOBI study, Cayston's performance noticeably deteriorated, as is the case with first-time TOBI users as well. On the other hand, Arikace's historical data shows far better durability.

    No matter the results, we can expect at least $200M in revenue, which corresponds to 10% market capture. Combine that with the value of the NTM indication and the stock is worth $20s before NTM PT results.

    However, considering that Arikace would share the CF market with only 2 other treatment options, Cayston and TOBI, it's likely to consider that it would capture between 20-30% of the market, which would correspond to $400-600M in revenue. But, for the time being, I'm going to stick with 10% as a conservative estimate. Chances are that in the long run the 3 big treatment options will be used cyclically by patients.

    One thing to note is that the open label P2 data, and the initial dose-ranging P2 trial, show strong durability, even increasing efficacy, with more cycles completed. If P3 data repeats this, it would put Arikace in a league of its own above TOBI and Cayston.

    So my target for post-P3 results is comfortably in the $20s.

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