The 30% fall in Amarin’s shares yesterday, even before the company's appeal hearing proper started, made it clear that few expected the group to hold off generic competition for Vascepa in the US. And now Amarin has officially lost its appeal, the group’s fate is largely down to European sales. One problem: Vascepa has yet to launch in Europe. The group only took the decision to go it alone on the continent in August and approval is not expected before early 2021. But launches in Europe are notoriously expensive, with slow ramp ups, due to the need to secure country-by-country pricing and distribution arrangements. It is also far from clear what the market opportunity is in Europe – much will depend on the price Vascepa can command. Leerink analysts had previously forecast $1bn in peak European sales, but looks ambitious, despite a heart benefit boost last year. Amarin also said it would be looking to approval in China, where it is partnered with Eddingpharm, and the Middle East to boost sales. However, despite the Amarin trying to put on a brave face shares fell another 4% this morning at the enormity of the news.