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A Heart Attack-Prevention Drug Disappoints…Wall Street

Mar 17, 2017

Happy St. Patrick’s Day. Today is quite possibly the 1,556th or the 1,557th or the 1,524th or anniversary of the death of this beloved Irish saint—which should sow enough confusion to turn any bar bet today into something truly unpleasant.

Which brings me to three other numbers that are liable to cause confusion: 27,500, 27%, and $14,000. Those are some key figures released today by Amgen in a highly awaited report of a trial called FOURIER. (What—you don’t want the acronym? Okay, fine: The “Further Cardiovascular OUtcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk” study.)

The trial tested an Amgen drug called Repatha against a placebo in a 27,500-patient (there’s one of our numbers) multi-nation, Phase 3, randomized, double-blind trial to see how effective it was in reducing the risk of nasty cardiovascular events. And the results were impressive. Repatha, a monoclonal antibody that substantially lowers LDL cholesterol in the blood, was shown to reduce the risk of heart attacks in patients (who already had evidence of atherosclerosis) by 27%. (There’s number No. 2.) The drug reduced the risk of “hard major adverse cardiovascular events” by 20%—but didn’t appear to affect overall mortality from cardiovascular disease (which wasn’t expected anyway.)

Repatha, which has to be injected, is also priced at $14,000 a year. (Number No. 3.)

So what happened? Naturally, Amgen stock tanked in early morning trading (My colleague Sy Mukherjee has a write-up in today's Fortune Brainstorm Health Daily newsletter). Why, you ask? Because many were expecting even more dramatic results—especially for a medicine with a $14,000-a-year price tag.

This, of course, is one of the challenges with chemopreventive approaches (at least from a drug maker’s point of view)—and why so many pharma companies don’t even try to develop medicines with the primary goal of disease prevention. It’s too knotty an issue to discuss in a few hundred words, so I’ll leave that for another time. But just take a second and imagine if the drug cured (rather than prevented) 20%...or 27%...of patients with a scary disease.

More on this topic soon.

In the meantime, I’m headed off for a short vacation. (I’ll be back with an opening essay for the newsletter on Tuesday, March 28.) In the meantime, Sy will take over the essays for Brainstorm Health Daily.

When I return, I should have some exciting stuff to report about our 2nd annual Fortune Brainstorm Health conference, which is taking place on May 2-3 in San Diego. We have some AMAZING speakers lined up—and some very cool surprises, too. It’s a by-invitation affair (sorry—I know that sounds rude), but if you’ve got a great story to tell in the field of digital health, and you want to apply to be a conference delegate, please shoot me an email.

This essay appears in today's edition of the Fortune Brainstorm Health Daily. Get it delivered straight to your inbox.

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