It comes up a lot that somehow LL would only be valuable to a company who owns an ICI. Which isn't true. There isn't a single pharma company, whether small, medium, or large, that wouldn't sell their souls for a blockbuster drug capable of generating tens of billions in sales per year. Who cares if another company also gets to make tens of billions because their checkpoint inhibitor gets chosen to be used in combination or after LL is initiated? Not the company that just doubled their income, I can tell you that.
But if a company that owns a Keytruda can add an LL? They'll just benefit twice as much? Either way though, we're talking tens of billions into the pockets of whichever company eventually owns LL. It's valuable to every last one of them.
And it won't be an issue if only one ICI is used in the trial and only that drug ends up in the approved indication. Doctors aren't dumb (in general, I mean. I've met some dumb ones) and oncologists will hear from colleagues, read case studies, see the approval, use their experience, and start putting LL to use in ways that it might not officially be approved for. It won't happen immediately, as caution is always used with brand new drugs, but it won't take long. Hell, by the time 2027 rolls around there'll be a lot more information about what LL can possibly do in other cancers or stages of certain cancers. That won't go unnoticed. But it won't matter to the company who owns LL as they'll get a prescription/sale no matter what ICI is going to be used. Along with all the other cancer patients who are going to be able to benefit with early use, before surgery, etc.
Once the indicated ICI goes generic it won't affect LL, it'll just affect the choice the doctor makes in adding the ICI 4-6 weeks after LL is initiated. Maybe it's too expensive for a patient to get the indicated combo, but if the doctor can use a generic ICI it cuts the cost in half and is now doable for that patient. Unfortunately, insurance has more of an effect on some patients than it should.
But if a company that owns a Keytruda can add an LL? They'll just benefit twice as much? Either way though, we're talking tens of billions into the pockets of whichever company eventually owns LL. It's valuable to every last one of them.
And it won't be an issue if only one ICI is used in the trial and only that drug ends up in the approved indication. Doctors aren't dumb (in general, I mean. I've met some dumb ones) and oncologists will hear from colleagues, read case studies, see the approval, use their experience, and start putting LL to use in ways that it might not officially be approved for. It won't happen immediately, as caution is always used with brand new drugs, but it won't take long. Hell, by the time 2027 rolls around there'll be a lot more information about what LL can possibly do in other cancers or stages of certain cancers. That won't go unnoticed. But it won't matter to the company who owns LL as they'll get a prescription/sale no matter what ICI is going to be used. Along with all the other cancer patients who are going to be able to benefit with early use, before surgery, etc.
Once the indicated ICI goes generic it won't affect LL, it'll just affect the choice the doctor makes in adding the ICI 4-6 weeks after LL is initiated. Maybe it's too expensive for a patient to get the indicated combo, but if the doctor can use a generic ICI it cuts the cost in half and is now doable for that patient. Unfortunately, insurance has more of an effect on some patients than it should.
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