Mandatory reading: Alan Carr’s Jan 2020 Antibacterial and Antifungal market review

Dear All,

Alan Carr has just released his Jan 2020 review of the antibacterial and antifungal market (link). For those of you not familiar with his work, Alan is an analyst for Needham & Company, LLC and has closely followed this space for several years. His newsletters are always deeply instructive and this one is no exception. You might also want to see my comments about his Sep 2019 review (link) and his very detailed March 2019 review (link).

Here are 3 top-line comments from the report, but you really need to read the entire thing:

  • “Developments in 4Q19 and early 1Q20 included Phase 3 results from Scynexis and Iterum, a Melinta bankruptcy, a large BARDA contract for Paratek, an FDA approval for Shionogi, and several relatively small financings.
  • “There were no notable changes in antibiotic or antifungal sales trajectories: Avycaz (Allergan), Cresemba (Astellas), and Dificid (Merck) continue to perform well relative to the rest of the group. Upcoming events in 1H20 include an FDA review decision for Contepo (Nabriva) and results from Phase 3 trials of sulopenem in cUTI and uUTI (Iterum), a second Phase 3 trial of ibrexafungerp in VVC (Scynexis), and a Phase 3 trial of enmetazobactam in cUTI (Allecra).
  • “We continue to believe the space is hindered by financial disincentives in the hospital setting and infrequent treatment guideline updates.”

As you read, note in particular:

  • The by-month sales summary (page 2) from Jan 2016 to Nov 2019 for the 18 branded antibacterials and antifungals approved since 2009 — data from this table are often quoted. If I’ve done my sums correctly, the US sales for the last 12 months (i.e., most of 2019) for this entire group of drugs were $805.4m (average of $45m/drug).
  • But, that average sales figure for the last 12 months is a bit misleading as sales were very unevenly distributed. If you ignore the one antifungal, 3 products had sales > $100m, 3 had sales of $50-100m, 1 had sales of $25m, and 10 had sales < $15m!
  • Colistin & polymyxin have declined a bit but continue to be used at substantial rates for CRE (page 4)! As I have noted before (link), we need updated guidelines to move the community to use of the newer generation agents.

All best wishes, –jr

John H. Rex, MD | Chief Medical Officer, F2G Ltd. | Operating Partner, Advent Life Sciences. Follow me on Twitter: @JohnRex_NewAbx. See past newsletters and subscribe for the future: https://amr.solutions/blog/

Upcoming meetings of interest to the AMR community:

  • [date correction] 4 Feb 2020 (1700-1830 CET, online): GARDP-sponsored webinar entitled “Non-traditional antibacterial therapeutic options and challenges.” Go here to register.
  • 12 Feb 2020 (Alderley Park, UK): “2020 Bioinfect Conference” sponsored by Bionow (link), the NW England life science accelerator. Go here to register.
  • 20 Feb 2020 (London, UK): Westminster Health Forum conference entitled “Antimicrobial resistance – coordinating a global response and progress on the UK strategy.” Go here for details.
  • 24 Feb 2020 (London, UK): One-day workshop hosted by Royal College of Nursing and the Longitude Prize entitled “Developing point-of-care diagnostics for urinary tract infections (UTIs): addressing clinical need in the UK.” Register here.
  • 26-27 Feb 2020 (Washington, DC): US PACCARB public meeting. Go here for details.
  • 27 Feb 2020 (1700-1830 CET, online): GARDP-sponsored webinar entitled “PK/PD murine infection models: Focus on study elements, variability, and interpretation of results.” Go here to register.
  • 1-6 Mar 2020 (Il Ciocco, Tuscany, Italy): Gordon Research Conference (GRC) on Antibacterial Discovery and Development: “Now is the time to re-boot antibiotic R&D before it’s too little, too late.” Go here for details.
  • 12-13 Mar 2020 (Basel): BEAM-, Novo REPAIR-, CARB-X-, DZIF-, ND4BB-, ENABLE-supported (among a long list!) Conference on Novel Antimicrobials and AMR Diagnostics. Details are here, poster deadline is 12 Dec 2019.  
  • 16-17 Mar 2020 (London): BSAC Spring Conference entitled: “Bridging the gap between science, policy and effective antimicrobial use.” Go here for details. 
  • 26-30 Mar 2020 (Atlanta, GA): CDC- and SHEA-sponsored 6th International Conference on Healthcare Associated Infections. Go here for details.
  • 30 Mar 2020 (everywhere): Deadline for applications for the Molecular Mycology pathogenesis course at Marine Biological Laboratory, Woods Hole. Now in its 24th year, the hands-on residential course runs 17 July to 2 Aug and gets rave reviews. Go here for more.
  • 9 Apr 2020 (everywhere): Final date for applications for NIAID/DMID call (link) for AMR-related vaccines, therapeutics, and diagnostics.
  • 18-21 Apr 2020 (Paris): Annual ECCMID meeting (#30)
  • 25-30 May 2020 (Rotterdam), Annual ESPID meeting (European Society for Pediatric ID, #38)
  • 18-22 Jun 2020 (Chicago), ASM Microbe 2020. Go here for details.
  • 27-28 Jun 2020 (Bryant University, Rhode Island): Drug Resistance Gordon Research Seminar entitled “Mechanisms and Approaches to Overcoming Drug Resistance in Cancer, Infectious Disease and Agriculture” for graduate students and postdoctoral scientists. Go here for details … this immediately precedes the GRC listed just next
  • 28 Jun-3 Jul 2020 (Bryant University, Rhode Island): Gordon Research Conference (GRC) entitled “Strategies to Disrupt Drug Resistance in Infectious Disease, Cancer and Agriculture.” Go here for details.
  • 1-4 Sep 2020 (Dublin): Annual ASM-ESCMID Conference on Antibiotic Development #5! Mark your calendar now and go here for details.
  • 9-10 Sep 2020 (Washington, DC): US PACCARB public meeting. Go here for details.
  • 22-25 Sep 2020 (Albuquerque, New Mexico): Biannual meeting of the MSGERC (Mycoses Study Group Education and Research Consortium). Save-the-date announcement is here, details to follow.
  • 17-25 Oct 2020 (Annecy, France): Interdisciplinary Course on Antibiotics and Resistance (ICARe). This is a soup-to-nuts residential course on antibiotics, antibiotic resistance, and antibiotic R&D. The course is very intense, very detailed, and gets rave reviews. The date is set for 2020 and the program will ultimately appear here. Registration is limited to 40 students and opens 15 Mar 2020.
  • 10-13 Apr 2021 (Vienna): Annual ECCMID meeting (#31)
  • 3-7 Jun 2021 (Anaheim), ASM Microbe 2021. Go here for details.

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