The Medicines Company's pain is Astra's gain

Faced with two almost identical antiplatelet drugs in its pipeline, AstraZeneca decided to license out one of them, cangrelor, to The Medicines Company in 2003 and retain Brilinta. Events this week could prove this was an inspired decision.

The release of encouraging phase III data for Brilinta (Brilinta data perks up Astra, May 11, 2009), has sparked significant share price gains this week in the UK pharma giant, whilst today’s news that The Medicines Company is terminating two phase III trials of cangrelor not only removes a potential competitor to Brilinta it also proves Astra picked the right drug. Meanwhile The Medicines Company was being severely treated by investors in early trade today, with shares crashing 43% to $6.40, a seven-year low.

Down, not totally out

The two phase III trials, initiated in 2006 and which had recruited 92% of the enrolment target of 15,400 patients, are being discontinued on the basis that cangrelor does not offer any efficacy advantage over the gold standard antiplatelet drug, Plavix, in patients undergoing percutaneous coronary intervention (PCI).

Whilst the drug’s chances of becoming a significant player in the antiplatelet market now appear over, The Medicines Company is not giving up on cangrelor altogether. On the basis that cangrelor, like Brilinta, has a fast onset of action and importantly is also reversible due to its short half-life, the company is now targeting the use of cangrelor in patients who have to stop taking Plavix for five days prior to cardiac surgery.

A phase II/III study, called Bridge, will enrol 200 patients and will aim to prove that cangrelor can inhibit platelet aggregation by at least 60% during these five days.

Hard lines

Although The Medicines Company has not completely abandoned cangrelor, the market’s reaction today suggests investors have made up their mind and written off the drug’s chances of ever reaching the market and providing any return on the significant investment a 15,000 patient trial must cost.

The severe drop in The Medicines Company’s share price today is understandable given that cangrelor was seen as a key growth driver for the company and has probably surprised investors whose hopes would have been raised by the Brilinta data.

Analysts had expected cangrelor to reach the market by the end of 2010 and pencilled in sales of $185m by 2013. In addition, the company’s revised and estimated enterprise value of around $180m is now significantly lower that the $225m it has spent on overall R&D in the last three years.

As such, the road to recovery for The Medicines Company looks like being a long and arduous journey, even to get back to the $16 share price the stock reached as recently as January.

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