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BLOG: Whither AzaSite, part whatever — I give up
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Has there ever a better medicine that had a rougher go than AzaSite? Seriously. AzaSite is the floppy eyelid syndrome of ophthalmic medications. Here we have a highly effective medication that can be safely put to use in the treatment of a very common, very disruptive disease state, and no one seems to be able to keep it in the marketplace. First Inspire crashes and burns when it can’t come up with a second act. Merck picks up the pieces and adds AzaSite to its small portfolio of ophthalmic meds. It then promptly bails on the entire eye care space, offloading AzaSite, as well as Zioptan and Cosopt, on Akorn. Then Akorn, with its sexy pipeline, ups and sells itself to the German company Fresenius.
Which promptly halts all efforts to support AzaSite in the marketplace.
Am I the only person who feels this way about AzaSite? I can’t decide if it’s the eye care equivalent of a “hot potato” in some twisted children’s game, or if maybe it ran afoul of an Egyptian mummy somewhere and is now cursed for all eternity. Just when it looks like it’s gonna catch a break (assigned to a specialty pharmacy that would handle patient cost issues), someone pulls the rug out from under it again.
To review, AzaSite is topical azithromycin in a DuraSite vehicle. It is only FDA approved for the treatment of bacterial conjunctivitis, which of course is the entire problem. Ninety-five percent of its use is in the treatment of meibomian gland dysfunction. AzaSite reduces inflammation in meibomian glands. This results in a reduction in the melting point of the secretion as well as a return to a normal carbon chain structure in the oil. At the slit lamp we see better tear function, most directly measured by an increased tear breakup time. Oh, and reduced patient symptoms. There were less than $20 million in sales in 2016. Properly managed, this is a $100+ million medication, easy.
Come on. Someone who gets dry eye disease needs to buy this drug. Whaddya say, Sun? There must be a little money left in the pot for a flyer on this, don’t you think, Allergan? Admit it, Shire: AzaSite would be a super add on to that little niche drug you just came out with. Someone? Anyone?
Bueller?
Disclosure: White reports he is a consultant for Bausch + Lomb, Allergan, Shire and Eyemaginations; is on the speakers board for Bausch + Lomb, Allergan and Shire; and has a financial interest in TearScience.