Chief medical Fool Brian Orelli thinks that newly approved multiple sclerosis drug Gilenya from Novartis (NYSE: NVS) might not grab much of the MS therapy market after all. But Teva Pharmaceutical (Nasdaq: TEVA), which makes established MS drug Copaxone, seems to be shaking in its boots.
Because I use Copaxone, Teva sends me marketing materials and life advice every now and then. The latest missive focused squarely on the rise of Gilenya, which is taken orally, and why I shouldn't rush to adopt this new, unproven, possibly dangerous therapy. The headlines in the newsletter, along with Teva's related arguments, include the following:
- "What we DON'T know" -- Gilenya is presumed to reduce immune cell counts, which can interfere with the body's natural defenses.
- "New vs established" -- "[L]ittle is known about [Gilenya's] long-term safety and efficacy."
- What we DO know -- Copaxone "is trusted, proven, and stands the test of time -- a smart choice in therapy today and well into the future."
Fire up the spinner!
OK, that's just regular marketing spin: point out the negatives of a new competitor while highlighting why your old solution is better. I get it. But the spin machine really goes into overdrive on the next page under the heading, "Let's look at how some people have made Copaxone a positive part of their daily routine." Teva's definition of "positive" is what I'd call "tolerable" at best:
- "It's routine, and it does not interfere with my life."
- "With Copaxone, you can choose when you want to do your daily injection."
- "Taking my shot every day is a part of a program of motivation to stay committed to being on this medicine regimen so I can be present for my kids."
Really, Teva? I log my injections in a nifty day planner Teva sends out every year. The injection pain typically rates between a 2 and a 4 on a 10-point scale, but sometimes it's a lot worse. My needle phobia isn't getting any better after two years of this hassle, and my insurance company gets billed more than $3,700 a month for the privilege of keeping me supplied. It must suck for UnitedHealth Group (NYSE: UNH) that I signed my Golden Rule health policy a year before this diagnosis, thus becoming a rather large cost center almost right away.
All I'm doing is slowing down the progression of my disease on a statistical level with no proof that Copaxone is actually helping me at all. But it's routine, done at my convenience, and I'm motivating myself to stay on the medicine just by doing it -- so it's all right. Right? Yeah, right.
But that's the best Teva can do here. Taking these shots is a hassle for some and a terror for others. There's just no way to make it sound pleasant, even in blatantly sponsored marketing materials. There is so much research activity around MS right now that I can't really fault Teva for running scared. But that's no reason to insult my intelligence like Teva just did.
Teva does have a point, though
I'm not jumping on the Gilenya bandwagon yet. As much as I hate my needles, the auto-injector at least makes the process bearable, even if I flinch every time I push that button. Competing therapies are even worse: Avonex by Biogen Idec (Nasdaq: BIIB) is an intramuscular injection, rather than Copaxone's gentler subcutaneous delivery and less brutal needle. Both Avonex and Merck KgaA's Rebif often produce flu-like symptoms that I would like to avoid. Elan (NYSE: ELN) and Biogen have a whole different ballgame in their Tysabri, and I'd be on that in a heartbeat if its brain-infection risks didn't scare the bejesus out of my wife. Plus, there's still a needle involved.
A pill such as Gilenya would be nice -- if early tests hadn't shown side effects like possible liver damage and bradycardia. The drug was first intended to treat rejection of kidney transplants, but was rejected because it was too toxic at the required dosage levels. The MS-approved dosage is far smaller, but do I really want to put toxins in my system on a daily basis, even at low levels?
Endgame
So I'm staying in the Copaxone camp because I don't like side effects, and many fellow MS patients are probably thinking the same thing. That doesn't mean that Teva can rest easy, and the company is in fact working on an MS pill of its own together with privately held Active Biotech. Other pills are being developed by sanofi-aventis (NYSE: SNY) and Biogen Idec, and chances are that at least one of these might be comparable to Copaxone in both safety and efficacy while beating it by miles in the convenience vector. That's where Copaxone becomes irrelevant and Teva can say goodbye to about $800 million of quarterly sales.
For now, I'm dealing with the Copaxone and actively enjoying the effects of my Ampyra pills from Acorda Therapeutics (Nasdaq: ACOR), which reduce my only symptom -- limping like a zombie -- to a minor nuisance. But I'll be waving a not-so-fond farewell to the needles the first chance I get. Teva can try to spin the convenience and (somehow) comfort of those shots all it wants, but I'm not fooled. It's just not quite time to take that plunge yet.
Until then, Copaxone remains the leading MS therapy and keeps growing its sales quarter by quarter. Enjoy that while it lasts, Teva. Unfortunately for Novartis, I agree with Brian's conclusion that Gilenya's success could be short-lived.
Follow the development of the MS drug market by adding major players like Elan, Biogen, and Teva to your Foolish watchlist.
