There's no nice way to put this: The current hepatitis C drugs stink. They're only able to cure half the patients treated with them, and they have horrible side effects to boot.
The poor efficacy and safety profile is the reason why Merck's
If you're thinking this might be a potential goldmine, you're not alone.
The frontrunners
Merck and Vertex Pharmaceuticals
An FDA advisory panel will review both Merck's boceprevir and Vertex's telaprevir on successive days next month. I expect both will get positive recommendations from the committees considering the unmet need, high efficacy -- cure rates in the 70% range -- and reasonable safety record.
The drugs haven't been tested head-to-head against each other, but based on their individual trials, Vertex and marketing partner Johnson & Johnson
Watch your back
While both drugs work better than current treatments and are even able to cure patients that failed previous treatments, they still require PegIntron or Pegasys to be taken alongside the oral medications. The treatment time can be shortened from 48 weeks down to 24 weeks, but that still means patients are injecting themselves and dealing with nasty side effects for six months.
We're headed toward an all-oral cocktail of drugs that doesn't require the current injectable drugs. Which drugs will be part of that cocktail remains to be seen.
The potentials are presenting plenty of data at the European Association for the Study of the Liver this week as they vie for a spot in the cocktail.
Novartis
Achillion Pharmaceuticals
Bristol-Myers Squibb
Pharmasset
Which one?
It's really too early to tell. Hepatitis C drugs seem to have a bigger issue with side effects than they do with efficacy, so investors shouldn't start jumping for joy just because the drug appears to be working.
How much of a threat the up and comers are to Merck and Vertex also isn't very clear. It's possible that they might try to latch on, combining their drugs with the front runners, rather than trying to take them head-on. Vertex has the clear advantage when combined with the current standard of care, which could mean a preferred seat at the combination table.