Good Combo; Too Bad There's Competition

Taking an injectable drug for three months is better than taking it for six months, but it's not as good as avoiding it altogether. What's a hepatitis C drugmaker to do?

Vertex Pharmaceuticals (NAS: VRTX) tested its experimental VX-222 with its recently approved Incivek, but the all-oral combination failed to keep the hepatitis C virus at bay.

As part of the same trial, the drug was combined with another oral medication, ribavirin, and Pegasys, which has to be injected. Patients taking the four-drug combo fared considerably better. At the higher dose of VX-222, half of the patients had undetectable virus levels at weeks two and eight, so they were able to stop the combination after just 12 weeks; all but one of those (93%) were virus-free 12 weeks after stopping treatment.

Those who didn't qualify to stop early remained on Pegasys and ribavirin for a total of 24 weeks, the current standard. Of the patients who completed the study, 100% had undetectable virus levels 12 weeks after stopping treatment.

If you combine the two treatment times and add in the dropouts, you still get a solid 90% response rate, with the added benefit that about half the patients can cut back on the time they have to take Pegasys.

If Vertex was the only one in this space, it would be sufficient for VX-222 to improve the current standard of care, but the hepatitis C treatment space is becoming increasingly crowded. Pharmasset (NAS: VRUS) has paired up with both Johnson & Johnson (NYS: JNJ) and Bristol-Myers Squibb (NYS: BMY) . Gilead Sciences (NAS: GILD) has six hepatitis C drugs in development. Idenix Pharmaceuticals and Inhibitex (NAS: INHX) have hepatitis C drugs in the clinic as well. And the list goes on.

Given the vast number of oral hepatitis C drugs in development, it's a safe assumption that some combination of medications is going to work as well -- and, more likely, better than -- the current treatments that require Pegasys or Merck's (NYS: MRK) PegIntron, which is also injected. Vertex's newest data is a positive because it shows that VX-222 has activity, but Vertex will need to find a home for it in an all-oral combination, whether through partnerships or acquisition. The four-drug combination that includes Pegasys just isn't a viable long-term solution.

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At the time thisarticle was published Fool contributor Brian Orelli holds no position in any company mentioned. Check out his holdings and a short bio. The Motley Fool owns shares of Johnson & Johnson. Motley Fool newsletter services have recommended buying shares of Vertex Pharmaceuticals, Johnson & Johnson, and Gilead Sciences and creating a diagonal call position in Johnson & Johnson. Try any of our Foolish newsletter services free for 30 days. We Fools don't all hold the same opinions, but we all believe that considering a diverse range of insights makes us better investors. The Motley Fool has a disclosure policy.

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