I see lot's of pontificating on either side of the issue about the merits, with each side arguing their cause twisting things as they see fit....here's the Letter. Decide for yerself:
February 13, 2013
We are writing to provide an interim update on the status of our pilot to #$%$ the use of OMONTYS® in the FMCNA dialysis facilities. The purpose of the commercial pilot is to determine the role of OMONTYS® as an alternative Erythropoiesis Stimulating Agent (ESA) on the FMCNA Formulary. The #$%$ment includes efficacy, safety and logistics related to this agent that was approved for use by the Food and Drug Administration at the end of March 2012.
We will now pause expansion of the pilot that began in late July 2012. We have accumulated experience in more than 56,600 administrations in over 18,000 unique patients. Two months into the FMCNA pilot program, the FDA released revised product information that added language similar to the prescribing information for EPOGEN® concerning the risk for allergic reactions, which we communicated to you in November 2012. To date, we have seen infrequent allergic reactions in our patient population receiving their first dose of OMONTYS®. Most of these reactions have been mild, but a small number have been serious. The rate of allergic reactions has been on the order of 1:1000 patients receiving a first dose of OMONTYS®. The vast majority of patients who are receiving the medication on an ongoing monthly basis are tolerating it well.
We are now working to analyze the full set of efficacy and safety profile information and feel that the current scale of our experience with use of the drug is adequate to complete this analysis. These results will be presented to our Corporate Medical Advisory Board with follow up reporting to our medical staff. In the meantime, this communication is to inform you of our confirmation of the adjusted prescribing information and the finding that such allergic reactions can occur in patients receiving the first dose of the drug. For patients on OMONTYS®, we recommend continued use of the agent as it has been providing effective anemia management. We plan to pause the rollout to additional facilities and patients at this time until the analyses are complete and reported to our medical staff. As many of you have become quite comfortable with the medication, physicians and facilities that have been using OMONTYS® who wish to continue prescribing it for new patients may choose to do so.
As we complete the analysis in the next week or two we plan to provide an update on the pilot experience and any future recommendations. I thank you for your participation in determining best protocols and practices around the use of OMONTYS® and we will update you with the analysis of our experience once complete.
With best regards,
Franklin W. Maddux, MD, FACP
Chief Medical Officer
Executive VP For Clinical and Scientific Affairs
Fresenius Medical Care North America
Jeffrey L. Hymes, MD
Associate Chief Medical Officer
Okay...just because this was more a swing trade for me, and I'm loathe to hold such over a week-end, I've closed my $12.75 "get" here at ~$16.41. I'll take the $3.66 "bird-n-hand" and re-eval next week.
All this kerfluffle is over a 1:1000 allergic reaction to a drug administration. They also state they've done 56.6K administrations (of the drugs) on 18K patients. 1:1000 basically means 18 patients had a reaction. And of the 18 some "small number" had a serious reaction. Well...first off...define "serious?" Leaving that aside this 18 number makes me think we're dealing with a major kerfluffle of a situation (heh). Disclosure....I took a gamble long position this AM just off the $12.25 line; playing the reaction. The aforementioned stat's alone make me think I got lucky with a correct move. Not sure how long I'll hold the position, though I've got it stopped (for now), just south of $15. Let's see what kind of shoe Fresenius drops next.
As I understand it, the problem is the chance of very serious adverse reaction to the administration of the first dose. We may be talking about patient deaths or worse. Of course, we can remedy this with an adequate disclosure of the risks with a Black Box type of warning. One suggestion: Omontys - The Hunger Games of First Dose Dialysis Medication.