Pharma vs Pharma: Glaxo gives new meaning to "OTB"

Typically, OTB refers to Off-Track Betting- placing legal bets on horse races from a remote location. Yet as the market for cancer drugs becomes increasingly more lucrative, we may have to accept a new meaning: Oncology-Trial Betting.

THE NEW OTB

GlaxoSmithKline (GSK) is apparently so confident of the data from its ongoing COMPARZ trial (primary outcome: progression-free survival), which pits their own pazopanib (Votrient) against Pfizer's sunitinib (Sutent) in patients with locally advanced, or metastatic, renal cell carcinoma, that they have promised to pay back the UK's National Institutes of Health (NHS) some percentage of the cost of Votrient if it fails to out-perform Sutent.

This cost rebate would be independent of an added 12.5% discount on Votrient's price- a discount that is said to effectively wipe out any premium over Sutent.

The National Institute for Health and Clinical Excellence (NICE) is recommending that the NHS accept the offer, since they had already figured out that this would be the only way to make Votrient cost-effective vis-a-vis Sutent.

Both Votrient and Sutent are oral tyrosine kinase inhibitors. Votrient targets vascular endothelial growth factor (VEGF) and platelet-derived growth factor, while Sutent targets VEGF.

IN THE US ...

According to the National Cancer Institute, the US FDA approved Sutent in 2006 for renal cell carcinoma and the agency approved Votrient in 2009.

Pivotal phase III trials of both drugs indicate that about 70% of patients taking either one will not have any response at all ... beyond, of course, those nasty side effects inherent in so many emerging anti-cancer drugs, such as liver failure, pneumonia, heart attack, and in many cases, death itself.

Forgive me this flippancy, but in the new OTB the only losers are the patients.