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Message: A comment about market penetration

Currently when a patient has a heart attack, they get admitted to a Coronary Care Unit. 

When discharged, they receive their list of prescriptions. What do they get now?

Almost all receive ASA, Plavix, Statin, B-blocker and ACE inhibitor. There is literally a checklist to make sure utmost consideration is given to prescribing these meds. That's why 80+% of this population is on these meds post-MI.

What do these meds have in common?

Evidence and a reasonable cost. 

That is why the PSCK9 meds are a non-starter for broad use. Cost is prohibitive and there is not even  a signal to a mortality benefit. 

Now, if BETONMACE shows the projected NNT for 3 point MACE and reduces mortality one could envision broad applicability. 

First, there would be a box - Diabetes? If yes, Apabetalone would be recommended as an add on to the above list. Market penetration would be quick. Big Pharma knows this. 

The importance of the NNT and price of Apabetalone slide in the Cowen presentation cannot be overstated. 

Finally, a positive BETONMACE trial would surely lead to a much larger trial with looser enrolment characteristics. If this trial were to be positive, Apabetalone would become standard of care along with ASA/B-blocker/ACE/Plavix/Statin. I imagine this trial would use an Apabetalone/Rosuvastatin combo pill. 

 

Bfw

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