Opinions on Exanta (ximelagatran)?

[MNnaloxone]

Anyone have any thoughts on this new drug that AZ is coming out with this year?

(I'm presenting on it for residency interviews, and want to make sure that nothing is left out.)

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[GravyRPH]

I'm sure you hit all the obvious high points, but have you looked at the effect it will have on the coumadin clinic outfits? Those boys and girls must be shaking in their boots.

 

[lord999]

I think like all new drugs, we need to do a wait and see approach.

Many drugs fail to live up to the hype, so I don't think anticoagulation is in deep trouble yet.

If we do have a winner on our hands, that will be an ironic end to one of the hardest topics in pharmacy.

 

[MNnaloxone]

Gravy-I plan on touching on the impact on anticoag clinics. I agree-I'd be looking for a different job soon if I were them. The convenience of not having an INR drawn regularly will be huge, especially for people who live in the sticks. I can use the example of North Dakota's VA system. ND has their VA hospital in Fargo. Untill they dropped a new clinic in Bismarck, vets from the west part of ND would have to drive 7 hours or more just to get lab tests. I wonder how many actually made the trip...

I saw that the cost for anticoagulation with warfarin is $1200-$1800 a year, plus $8K for the average adverse effect. AZ would have to set their price points stupidly-high for doctors to not switch over in droves, and for insurance organizations to push for the switch.

From the commentary I've been reading, warfarin won't be immediately shoved to the closet-Exanta has to win a lot more indications. I agree that we have to see what the phase IV's come up with, but there have already been 30,000 people exposed to this drug through trials. While I'm not saying that's wholly representative of a population, it is a pretty good start.

Thanks for the input, guys!