Epigenomics auf dem Weg zur FDA Zulassung?!
Meine Antwort auf Seeking Alpha im EXAS Lager:
@Skaterdude
I perfectly understand. If somebody is invested and very convinced about his investment it might be the case that other opportunities/views are not taken into consideration.
Off course Cologuard has better performance data than FIT regarding sensitivity: 68% vs 92%. However, when it comes to specificity FIT is even better with 95% vs 87% for Cologuard.
You are also right: if something is cheaper it is not necessarily better.
The point is: If adherence rate has been remaining almost the same since 10 years between 65 and 68% why should a test that like FIT/FOBT urges the patient to stir into feces increase that rate to 80%?
Right through tremendous market and sales efforts by Mr. Conroy some more tests will be sold. He spent 40 mln. of marketing budget for a TV campaign, EXAS has its own lab with own lab workers performing the test and an own sales team. cash burn factor is high... Question is when will the company earn money - not in 7 years. So what FIT and FOBT producers never reached Mr. Conroy tries to accomplish within say 4 years.
Off course, I see at the moment the market is celebrating every new insurance that covers Cologuard but that says nothing about compliance rate.
That is why it is worth sometimes to look beyond his own nose. Epigenomics provides the only and ever FDA approved blood test for CRC detecting. A German-American company with an American CEO, Mr. Hamilton. If you like Mercedes, fine German engineering, you may like the test, Epi ProColon, as well. With no argument performance data of Cologuard is better. But this is not the point. The point is a new disruptive approach in CRC screening - liquid biopsy. When FIT/FOBT nor colonoscopy was not able since 10 years to leverage adherence rate Epi ProColon may do the difference but certainly not Cologuard.
We talk about 32 min. eligible but unscreened US Americans. Does it sound like an interesting market? If Epigenomics just reaches a fraction of that it will earn a lot of money. This is why the company has less cost. It thrives on the established sales structures of Polymedco and LabCorp - it is a CLIA Test, FDA approved since April 2016. Recently, recommended by USPTF. And if the US ministry of health does not pay just a lip service when it comes to increase of compliance rate to 80% for CRC screening until 2018 one can be sure the EpiProColon also gets reimbursement by CMS and others. Maybe it is just a co-payment of 159$. However the test costs only 349$ or maybe less.
I don't want to dissuade you from staying in EXAS shares but it may be worth also to have a closer look to Epigenomcis: ISIN: US29428N1028 Also available on NASDAQ as ADR (OTC)
If you like read this interesting article:
http://www.clpmag.com/2016/06/...track-easier-screening/?ref=cl-title
seeking alpha hat eine großen lesekreis (und investitionskreis)
Für mich befindet sich der Epi-Zug im Bahnhof zur Abfahrt bereit (keine Handelsempfehlung). Alleine die Vertreteranzahl, die auf Epi trainiert werden als Multiplikator ...
@HAL2016 #5548, hatte mir auch überlegt, den Beitrag von gp Karite hier zu posten; besser (schöner) kann man es nicht ausdrücken und damit ist vieles geschrieben. Er könnte auch (lingusitisch) der User jamannn hier sein.
Good luck uns allen!
für mich gibt es als vorbeuge in erster linie den test... die möglichen nebenwirkungen der k. habe ich jetzt zwei tage live miterlebt. bestimmt ist es bei vielen nicht so schlimm, aber das risiko muss man nicht haben.
n.m.m.
First off, the adherence rate for FIT is nowhere near 65-65%.
A study by the VA Hospital found a 5 year compliance rate for FIT at only 15%. And a recent Journal of Managed Care publication from May 2016 highlighted a study performed by the policy division of United Health Care (called Optum) that showed that actual USPSTF guideline adherence to FIT for 10 years is 3 out of 1,000 people. This study was a real world study based on insured members of United Health who had been insured for 10 years and who were at average risk.
The Epigenomics test, Septin9 has a terribly high false positive rate and sensitivity is poor. People don't seem to understand that colon cancer lives in its own little "eco-system" in its early stages and does not show up in the blood. Thus, a serum based test like Septin9 is fraught with inherent biological limitations.
Furthermore, it is not reimbursed by Medicare (CMS) and thus leaves out half the addressable market.
Meine Antwort:
@special
Adherence rate to Epi ProColon vs. FIT:
http://www.epigenomics.com/news-investors/...lnehmerrate-von-995.html
Sensitivity of ProColon is 68-72% and specificity is 80% shown in two large US studies and basis for FDA approval in April 2016.
Your claim that EpiProColon does not find CRC in early stages is wrong:
Sensitivity:
Stage1: 41%
Stage2: 83%
Stage3 80%
Stage4 100%
Total cancers 68-72%
Off course, performance of Cologuard is better but this is not the point. It is about having an additional tool for CRC screening or why do you think adherence rate for CRC screening of 65-68% remains since 10 years the same?
Even though in 20% false positives colonoscopy finds in 58% of those cases lesions, polyps that get resected while colonoscopy is performed. So colonoscopy was not for nothing in those cases, especially in a health care system where everybody should undergo it within 10 years at least.
Epi ProColon is completely differently positioned in contrast to Cologuard - which is basically just another stool test.
It aims at the 32 mln. US Americans (a 2 billion market) who are not willing nor want to undergo FIT/Cologuard or colonoscopy. Do you think that a patient decides for Cologuard because of its performance data? Obviously, the unwilling want to have a different approach and they find it in a blood test, like ProColon.
Pro Colon is at the moment not reimbursed as mentioned before but negotiation is already initiated by our US CEO, Mr. Hamilton. It takes some time but will come.
Let's see who wins the race! Especially if I look at the tremendous cost of EXAS...the article says it.
Aber wievman sieht steigt der Kurs vor der Zulassung höher als nachher.
Bald ist auch das Sommerloch vorbei und vielleicht sind die Aussichten trotzdem sonnig, wenn immer mehr Anleger an einen Erfolg von Epigenomics glauben!
von der homepage
Epi proColon Question and Answer
Q. What are the benefits of screening with Epi proColon?
A. The benefits of screening with Epi proColon include:
Fast and easy to use
Early diagnosis of colorectal cancer (CRC)
Detection of methylated Septin9 DNA that is associated with colorectal cancer
It is a minimally invasive blood test and an approved method of testing colorectal cancer
Epi proColon is can be used for screening colorectal cancer (CRC) when a patient is unwilling to undergo colonoscopy or other recommended screening methods.
Q. What makes the Epi proColon test better than other CRC tests?
A. The Epi proColon test is a convenient, fast and easy test for colorectal cancer (CRC) screening. It can be performed during a check-up or doctor’s visit. It does not require any dietary restrictions or alterations in medication use. The sampling can be standardized and the test provides reliable results.
Other CRC tests require more time and effort and to execute. The sampling cannot be controlled, hence resulting in application errors.
polymedco gibt gas :)
Ich habe auf seeking alpha einen sehr kritischen Analystenbericht zur aktuellen Kursentwicklung gelesen. Hier geht es um folgende Punkte:
1.) exorbitante Marketing- und Sales ausgaben (TV Werbung, eigenes Sales Team) und das dies nicht nur ein one-off ist, sondern inherent dem Business Model ist
2.) dass EXAS die Ausgaben wie ein big Pharma Unternehmen hat, aber dafür über ein Produkt mit relativ geringer Marge verfügt
3.) dass das Thema Erstattung viel zu sehr von der Börse gefeiert wird, denn obwohl ja durch die USPSTF Entscheidung jetzt alle screening Maßnahmen gleichwertig sind (auch Epi ProColon), heißt das nicht, dass uneingeschränkt erstattet wird. Dies gilt insbesondere bei Cologuard, der einfach mal 549,- $ kostet. Laut eines Antwortschreibens aufgrund einer Anfrage der Analysten, sagt eine Versicherung (Blue Cross), dass bevor Cologuard dem Patienten voll erstattet wird, müssen eine ganze Reihe von Vorbedingungen erfüllt sein: u.a., dass bspw. ein FIT Test oder ein FOBT Test in den letzten 3 Jahren nicht stattfand, eine Koloskopei in den letzten 10 Jahren nicht stattfand, etc.
Warum? Weil Cologuard nur ein weitere Stuhltest mit einer besseren Sensitivität zwar aber 18 fach teuerer als FIT ist. Also die Versicherungen lassen sich da auch nicht foppen.
Nun stellt sich die Frage, wie es sich mit Epi ProColon verhält? Sicherlich kann es hier auch diese Vorbedingungen geben, für Patienten, die "up to date" mit screening sind. Allerdings ist das ja auch nicht der Markt. Es geht ja um die 32 Millionen Unwilligen (2 Mrd. Markt) Darüber hinaus kann der Ansatz (Bluttest) differenziert von der Stuhlprobe tatsächlich auch die Versicherungen positiv auf Pro Colon stimmen.
Fazit: Erstattung ist nicht gleich Erstattung. Hier der Artikel (Ihr müßt Euch anmelden)
http://seekingalpha.com/article/...&commenter=1&comments=show
PSalerno
Truth to be said, this article was published on Tusday before market opening when the stock closed around 21.50. He probably shorted Monday around 22, I tried to short buying puts , but my order was unable, if filled I would have covered after 24 hours. The short was well timed from a technical and valuation point of view as EXAS went below 20 and yesterday closed around that level. The only point where I disagree is when he says the forecast made by the analysts are too high. Here I agree with SBull and think the numbers will be higher. Conversely the forecasts made by the bulls publishing on SA and commenting here are too high. There is no way for EXAS to make 4 Million tests every year in the foreseeable future. I destroyed the bull thesis made by Harvey Gillis, Spano and others here with a 200 target and 10-14B revenue, but also the bear thesis made by Tilson.
The author is absolutely correct that insurance companies cannot be forced to pay Cologuard if other tests have the same efficacy, at least not always. There is no specific A rating for Cologuard. The stock price can go higher or lower depending on news flow, but the company is far from being profitable, there is a stock dilution going on, it is good for trading not for long term investing, as many things good or bad can happen.
Meine Antwort
@ PSalerno
hm, I also have a question: The analysts in the article above did a request to Blue Cross whether the insurance company would reimburse the test. So obviously Blue Cross has a lot of pre-conditions, i.e. :
- the patient should not have had a FIT within the last 3 years or
- FOBT within 1 year or
- colonoscopy within 10 years.
This is indeed understandable, since no insurance company wants to pay an 18 fold price for a stool test that is basically delivering the same result (92% for Cologuard vs 68% sensitivity of FIT is better, off course)
that means basically that Blue Cross will not reimburse Cologuard if the patient is up to date in CRC screening, right?
This again means that the market for EXAS is restricted the unscreened or the patients who are willing to pay 549.00 $ out of their own pocket (which is a minor group).
So the target group is the same as of Epigenomcis. So we have a stool test and a blood test in a market of 32 mln. US Americans (the unscreened and unwilling). Since years compliance for screening remains between 65-68%, since people refused any of the offered screening methods, naming stool tests and colonoscopy, etc I don't know how the blood test works out. Either it is a game changer or not.
Cologuard costs 549.00, Epi ProColon app. 349.00 (i.e. at the moment in Arizona). EXAS has big overheads for marketing and sales, cost of its own Lab, performing the test by itself.
Epigenomcis has a CLIA test that can be performed in all U.S. labs and no sales structure as it relies on Polymedco and Labcorp with big sales teams.
That is why I also would be short or at least in a trading mood on EXAS.
1. Nachgekauft 700 Stück
2. Mein Hausarzt kennt Epi jetzt und empfiehlt diesen Test. (Vor 1 Jahr kannte er ihn noch nicht)