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Expert Interview

Slingshot members are talking to an expert! The topic is:

Checking the Launch: How is Ingrezza fairing in the early days of commercialization?

Ticker(s): NBIX, VRX, TEVA

Who's the expert?

Name: Dr Joseph Jankovic - MD

Institution: Baylor College of Medicine 

  • Professor of Neurology, Distinguished Chair in Movement Disorders, Founder & Director of the Parkinson’s Disease Center and Movement Disorders Clinic at Baylor.
  • Currently has 5 of 250 patients with Tardive Dyskinesia on Ingrezza.
  • Participated in the pivotal Huntington's Disease trial for Austedo.

Interview Questions
Q1.

Please describe your background and experience treating patients with TD. How many patients with TD do you currently see?

Added By: joe_mccann
Q2.

What is the current treatment protocol for patients with Tardive Dyskinesia? How would you describe the effectiveness of current treatments? 

Added By: joe_mccann
Q3.

Ingrezza does not require a black box warning, unlike Teva's Austedo, which has a PDUFA in TD in August 2017.

  • If given the choice, would there be any reason a physician would put patients on Teva’s deuterated product vs. Ingrezza, given the boxed safety warning and inferior efficacy and dosing regimen?
  • How do you think this will this affect the commercialization and market share of both products?

Added By: joe_mccann
Q4.

There are no other approved products for TD, but Valeant's tetrabenazine, benzodiazepines, clozapine, or botulinum toxin injections also may be tried in treatment. How would you describe the effectiveness of tetrabenazine, and these other forms of treatment that are sometimes used? 

Added By: joe_mccann
Q5.

What has been your experience in prescribing Ingrezza? Have you had issues with payor approval?

Added By: joe_mccann
Q6.

A recent survey of Payors indicated the following planned restrictions. Can you please comment on your view of each in terms of burden and degree of restriction.
a) limit to moderate to severe patients (80%)
b) switching antipsychotic step edit (65%)
c) AIMS score for severity or physician comments
d) timed follow-up by a physician to ensure a response was achieved (mean follow-up time 8 weeks) 

Added By: joe_mccann
Q7.

Are there any other drugs currently being developed that could disrupt the market for TD drugs? 

Added By: joe_mccann
Q8.

The label for Ingrezza is very clean and benign vs. Austedo.  Was this something you expected or did you anticipate seeing other warnings, restrictions, etc...

Added By: joe_mccann
Q9.

How aware of Ingrezza's approval are psychiatrists or providers that typically treat TD?  Is this a physician group that is generally conservative or are they receptive of new therapies?

Added By: joe_mccann
Q10.

If we assume Ingrezza's sales force will be highlighting the lack of dose titration, faster onset, once a day dosing, lack of food requirement, tolerability of the drug, etc... Please discuss how meaningful these attributes will be in the real world setting.  

Added By: joe_mccann

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