Analysis: Superbugs driving blockbusters

By STEVE MITCHELL, UPI Senior Medical Correspondent  |  March 7, 2007 at 9:09 PM
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WASHINGTON, March 7 (UPI) -- The emergence of multi-drug-resistant superbugs as a global health concern appears to be propelling antibacterial drugs to blockbuster status, according to an analyst report issued Thursday.

Treatments for community-acquired infections have historically dominated the sector, but the trend is now shifting in favor of hospital infections, such as methicillin-resistant Staphylococcus aureus, or MRSA, predicts the report from Datamonitor.

"We predict the hospital market is going to take over and be the main growth driver of the antibacterial market," Hedwig Kresse, the author of the report and an infectious-disease analyst with Datamonitor, told United Press International.

There are several reasons for this, including the increased attention given superbugs, or bacterial infections that are resistant to multiple drugs. In addition, many community-acquired infection treatments are losing patent protection and the population is aging, which will lead to more infections and treatment in hospitals.

"The community market is pretty much exhausted for big pharma, so companies are focusing on the hospital market because they can achieve higher prices there," Kresse said.

Two drugs that stand to benefit from this trend are Pfizer's Zyvox and Wyeth's Zosyn.

Zyvox sales are ramping up due to the rise of MRSA, and the drug will likely achieve blockbuster status in the next few years.

"It will reach sales exceeding $1 billion by the end of the decade," Kresse said.

Zosyn, which is given intravenously for nosocomial lower-respiratory-tract infections, is growing at a very strong rate that is expected to continue until the patent expires later this year, Kresse said. The drug is expected to generate approximately $900 million in sales this year, she added.

The most promising compounds in late-stage development for MRSA include Pfizer's dalbavancin, Theravance's telavancin, Johnson & Johnson's ceftobiprole and Arpida's iclaprim.

All of these drugs are expected to generate somewhere in the neighborhood of $500 million in sales, Kresse said. Dalbavancin and telavancin are the furthest along and are expected to be launched in the United States this year.

Zyvox may be impacted a little by the additional competition, but Kresse said this is expected to be minimal because "any help on the resistance side is appreciated and highly necessary."

Danielle Drayton, an analyst with Decision Resources, told UPI the pipeline for anti-MRSA agents is "really saturated."

The compounds that look the most promising in her view include telavancin and Targanta's oritavancin.

These two drugs are "poised to compete with vancomycin, the gold standard of treatment," Drayton said.

But they probably won't knock vancomycin off as first-line therapy because it's both cheap and effective.

Telavancin and oritavancin will enter the market "with a high price premium and really don't offer significant advantages in efficacy," Drayton said.

Two drugs currently on the market that are gaining traction against vancomycin include Zyvox and Cubist's Cubicin, she said.

Sylvia Eash, an analyst with Decision Resources, told UPI an area of hospital infections that has gone neglected is gram negative pathogens, which includes Pseudomonas aeruginosa and Acinetobacter baumannii.

One reason pharmaceutical companies have not been interested in this area, Eash said, is that the affected patient population is relatively small. However, it could be a lucrative opportunity.

"Drugs that enter that space would be able to command very high price premiums," she said.

Currently, carbapenems are the top class in this area. This includes Merck's Primaxin and AstraZeneca's Merrem.

Primaxin's U.S. patent expires in 2009, after which "sales will decline dramatically," Eash said. The drug is expected to generate sales of $340 million in 2010.

Merrem's U.S. patent expires in 2010, and the drug is forecast to bring in sales of $170 million.

Johnson & Johnson's new carbapenem, doripenem, is expected to launch later this year and compete with Merrem.

Doripenem doesn't offer many clinical advantages, but J&J may be able to gain traction by bundling it with two of its other antibacterials, including ceftobiprole, Drayton said.

The problem though is that carbapenem-resistant infections are starting to emerge.

"So what's left when you really have a very serious infection?" Drayton said. "The answer is there really is nothing."

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