Michael J. Nestor
Analyst · Bank of America.
Well, I think relative to the differences between IPX066, Rytary and Vadova, they are completely different products. Vadova, when it was originally formulated, was just the immediate release carbidopa-levodopa joined with controlled-release carbidopa-levodopa, and FDA's concern there was that there would be confusion on the part of physicians because in many cases when the controlled-release carbidopa-levodopa is given, typically, it's also given with an immediate-release carbidopa-levodopa. And with Vadova having both components, they were concerned that physicians would additionally, as they had consistently with the generic controlled-release carbidopa-levodopa, add yet another immediate release carbidopa-levodopa to that mix. And they therefore felt that the potential downsides relative to the benefit were not there. So IPX066, Rytary, however, is a completely different product in the sense that it is a specific formulation of carbidopa-levodopa that contains within it various release drivers, if you will, for carbidopa-levodopa that allows us to extend the effect of carbidopa-levodopa that we believe in part is consistent and leads to the very good results that we've seen with the clinical trials that we've done with Rytary. Now in terms of differences relative to Vadova and Rytary and why we believe Rytary would be approved whereas Vadova was not. First off, it's the basic fundamental formulation for the product. As I said earlier, this is very different from what Vadova was. Secondly, we have completed the Phase III clinical trials; the apex PD trial in levodopa-naïve patients; the advanced PD trial, which was a head-to-head comparison with Sinemet CR or immediate release carbidopa-levodopa, where we showed statistically significant improvement over the immediate release carbidopa-levodopa. And thirdly, with our [indiscernible] PD trial, which was a head-to-head comparison with carbidopa-levodopa intact component, where we also showed highly statistically significant improvement over the CLE formulation. Based on that, we feel that what we're looking at here is a very different scenario for Rytary relative to what the whole Vadova concept was. So we think it's 2 totally different realms to consider, and the only one that's really on the table for any approval, obviously, at this point and for which the appropriate data points exist is Rytary.