I appreciate your work! I'm really looking forward to part 2. As another mentioned, curious of your thoughts on MEDXF's competition risk and whether MOB's formulation of terbinafine is superior (MEDXF plan to commercialize topical terbinafine hydrochloride nail lacquer supplied by Polichem, estimates the total value of the Canadian fungicides market to be C$88 million annually)
That’s coming straight from Anna. No possibility for acceleration because of a combination of terbinafine supply, the complexity of launching so many countries at once (highly unusual), and wanting to get the label changed prior to launch in the event of a successful phase 3.
Hey, thanks for this writeup- really appreciate your taking the time to write out the case to let folks test your assumptions.
Just to be clear though- for Europe, your sensitivity assumes a 3% treatment rate by MOB-015 in the downside case?
Yet per the Bausch Canada case earlier, the treatment rate across ALL treatments (the entire market) combined equals just 1.8%? It seems optimistic that MOB-015 increases the market size by 66% then takes 100% of that grown market?
Thanks John. My sense is the Bausch dataset is likely incomplete, especially given the rate of ciclopirox and terbinafine prescriptions in the US around 4.2%, which if anything is an underestimate itself. I think it would be reasonable to expect the two are comparable.
Also, I should have said made this clear in the piece, will probably make an edit to reflect:
OTC products are going to be higher market penetration than their Rx counterparts because of accessibility. So if you have 4% treatment rates in NA, the EU OTC rates should be higher, and it should be dominant when it’s coming into a market with no effective fungicides selling OTC. So I personally think 3% is a very doable rate of EU TAM capture some years after launch.
I have seen no indication they plan to do this habitually or on a grand scale. Her temperament (and that of the company generally) suggests to me it’s unlikely to be an issue. There are large shareholders who are very focused on ensuring capital is allocated efficiently. I’m not concerned.
From the preceding paragraphs on Canadian and American prescriptions. It’s an approximation I arrived at on my own. I was unable to find anything online detailing treatment statistics.
I appreciate your work! I'm really looking forward to part 2. As another mentioned, curious of your thoughts on MEDXF's competition risk and whether MOB's formulation of terbinafine is superior (MEDXF plan to commercialize topical terbinafine hydrochloride nail lacquer supplied by Polichem, estimates the total value of the Canadian fungicides market to be C$88 million annually)
Thank you, yes that will be addressed
Given the success in Sweden, why do you think the European OTC launch will take until 2026? Any insight if that can be accelerated?
That’s coming straight from Anna. No possibility for acceleration because of a combination of terbinafine supply, the complexity of launching so many countries at once (highly unusual), and wanting to get the label changed prior to launch in the event of a successful phase 3.
Hey, thanks for this writeup- really appreciate your taking the time to write out the case to let folks test your assumptions.
Just to be clear though- for Europe, your sensitivity assumes a 3% treatment rate by MOB-015 in the downside case?
Yet per the Bausch Canada case earlier, the treatment rate across ALL treatments (the entire market) combined equals just 1.8%? It seems optimistic that MOB-015 increases the market size by 66% then takes 100% of that grown market?
Thanks John. My sense is the Bausch dataset is likely incomplete, especially given the rate of ciclopirox and terbinafine prescriptions in the US around 4.2%, which if anything is an underestimate itself. I think it would be reasonable to expect the two are comparable.
Also, I should have said made this clear in the piece, will probably make an edit to reflect:
OTC products are going to be higher market penetration than their Rx counterparts because of accessibility. So if you have 4% treatment rates in NA, the EU OTC rates should be higher, and it should be dominant when it’s coming into a market with no effective fungicides selling OTC. So I personally think 3% is a very doable rate of EU TAM capture some years after launch.
Great summary. Looking forward to part 2.
Thank you Dean
In part two, will you write about:
1-medexus as threat
2- if phase 3 trial fails: likelywhood of fda approval as daily dosage?
Absolutely
How serious is the plan of being a platform company and buying other drugs? Did Anna mention it often? I'm a little concerned now.
I have seen no indication they plan to do this habitually or on a grand scale. Her temperament (and that of the company generally) suggests to me it’s unlikely to be an issue. There are large shareholders who are very focused on ensuring capital is allocated efficiently. I’m not concerned.
Great write up
Thank you Sean
I am curious, where did you get the 95% onychomycosis patients get left untreated?
From the preceding paragraphs on Canadian and American prescriptions. It’s an approximation I arrived at on my own. I was unable to find anything online detailing treatment statistics.
Gotcha, thanks for clarifying!