Betting the Pharm OpEd by John Mack

Pfizer’s failure to launch torcetrapib will have repercussions throughout the industry on many different levels. As a seminal event, it will rival the withdrawal of Vioxx from the market.

First, it is “devastating to Pfizer” whose executives bet big on torcetrapib as a replacement for Lipitor, which will go off patent in 2010.

Pfizer Chief Executive Jeffrey Kindler believed that torcetrapib was “one of the most important developments in our generation” and Pfizer research president John LaMattina said, “We believe this is the most important new development in cardiovascular medicine in years.”

These executives as well as every Pfizer employee must be in shock and awe. Shocked that their company could fail so publicly and awed by the power of the butterfly effect that a rise in a few millimeters of mercury of blood pressure can have.

Second, the failure of torcetrapib will likely lead to further layoffs of sales and marketing people at Pfizer on top of the previously announced 20% cut.

While Mr. Kindler says he is “relentlessly focused on shareholder value,” some $20 billion of it evaporated on Monday, according to the Wall Street Journal. That makes the $800 million Pfizer claims to have spent on development costs look like a rounding error. Some analysts are predicting that Pfizer will have to buy new drugs for its pipeline through mergers and acquisitions and this will speed up M&A activity throughout the industry.

Torcetrapib problems may have resulted from raising the level of “bad” HDL. If so, that would signal trouble for the entire class of CETP inhibitors. “The whole class goes down at that point,” said Steven Nissen, chief of cardiovascular medicine at the Cleveland Clinic.

The visible failure of Pfizer’s prize replacement for Lipitor may also be sending a chill through the public, which could be losing confidence in Lipitor and other lipid-fighting drugs despite the lack of any supporting scientific evidence.

Finally, the torcetrapib failure puts a monkey wrench into the ascendancy of commercialization over science. Some experts claim that, like it or not, “we are in an era where development of ‘successful’ drugs is going to be shaped by potential marketplace success” rather than clinical efficacy.

Torcetrapib may have been one of these drugs shaped more by commercial potential-ie, blockbuster potential-than by any viable science to back it up.

A recent article by an assistant managing editor at The Wall Street Journal questions this strategy and suggests that Pfizer and the rest of the pharmaceutical industry needs to change its “creaky traditions,” including how it develops drugs, sells drugs, and manages public opinion. Amen!

Issue: Vol. 5, No.10: December 2006

Word Count: n/a

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