Re: I think we're over the hump
Ernie, I appreciate your measured attitude. But, let me point out the following.
The KCentra study, while being Portola sponsored, is still evidence with nothing to refute it. And, it will be used in lawsuits. The fact is, there's no evidence based study to show that Kcentra is effective against Xai. FDA has not approved it for use in this indication. And, guidelines are starting to come out directing hospitals to be aware and stock appropriate antidotes for appropriate blood thinners. This is important in lawsuits. People are still dying in comparable numbers as before from Xarelto and Eliquis bleeding. Andexxa has not made significant inroads yet. The recent lawsuit against Xarelto cost nearly 1 Billion dollars to settle even though so many factors were in Xarelto's favor. The main complaint was lack of antidote. Now, there is antidote. The tens of thousands of lawsuits will now turn it's attention on who didn't use the correct antidote and why. If the answer is, "we used Kcentra because it's cheaper,' that will not fly well in courts. They'll have to say, it's standard practice. But, Xarelto is standard practice and they still had to fork over a lot of money.
When lawyers point out that there are studies showing Kcentra is ineffective in their client's case, defense becomes harder. Over time, this will be felt on the hospital administrators.
Second, 'C Code and NTAP is fairly huge development, not just fuel to the fire. The cost is the only obstacle everybody talks about before Andexxa gets 'used like water.' Well, NTAP covering further 4,000+ dollars is pretty big for hospitals weighing the impact of 6-7K per dose hit. Surely, 2-3k hit per dose can be fitted under DRG. In fact, I wonder if Kcentra has become more expensive compared to Andexxa at that price point. That is a very significant development. I mean, what incentive is there to use Kcentra (not FDA approved against Xai) over Andexxa (FDA approved) when cost is not a factor?