Go Big or Go Home Pt.2 2.0

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kmall
Posts: 45
Joined: Thu Mar 21, 2019 3:57 pm

Go Big or Go Home Pt.2 2.0

Post by kmall » Sun May 31, 2020 4:52 am

(cont.).........

4. Poverty / Economic Conditions – This (2015) abstract / article from Pakistan, which also mentions Iran, touches on insufficient treatment due to economic conditions; “a lack of expertise and a sky rocketing cost of transplant in the private sector. Eventually all the high and very high-risk cases do not even survive for more than a year.” “While from Iran median MDS survival as a whole, without any disease or risk categorization is only 14.6 months.”

https://medcraveonline.com/HTIJ/myelody ... tions.html

5. Rural / “Undeveloped” Countries / Ethnicity – A (2015) abstract from South America discusses not only several countries in that continent, but multiple ethnic differences around the globe (Japan, Germany, New Zealand, Australia, Chile, Brazil, Argentina) while highlighting the challenges of registry in certain geographical locations.

“The incidence and clinical characteristics of patients with MDS varies by geographical area, and this has been attributed to genetic or ethnic, occupational, lifestyle, and environmental factors, that have not been fully elucidated 9, 22. Socioeconomic status may also influence the outcome of the disease 23. Knowledge on epidemiological characteristics of MDS is often based on statistics from selected local populations. On the other hand, there are some growing data from cancer registries 14 or from ongoing programs such us the SEER in US 11. Because of the lack of large, population‐based studies, and Cancer Registries supported by each government, the incidence of MDS in SA has not been well documented yet. This is the first study, which attempts to describe demographic, clinical features and outcome of patients with MDS from SA comparing patients from Argentina, Brazil, and Chile.”

https://onlinelibrary.wiley.com/doi/ful ... /ajh.24097

6. Misdiagnosis – This 2019 study from data collected between 2016 – 2018 “Shows Misdiagnosis Common For Patients With MDS”

“Dr. Sekeres and his co-investigators found disagreements between the original diagnoses and that of the central lab in 40 percent of the 375 cases, and later analyses showed that those disagreements were clinically meaningful in 26 percent of patients. “It’s a huge number of patients,” says Dr. Sekeres. “Almost 100 patients out of 375 had a clinically meaningful change in their diagnosis.”

“if a patient has abnormal blood counts but doesn’t quite reach the definition of MDS in the bone marrow, the detection of genetic mutations might help in correctly classifying the person as having MDS, which would influence treatment decisions.”

“In other words, we have a problem with our national interpretation of the epidemiology of MDS.”

https://consultqd.clevelandclinic.org/n ... syndromes/

As we can clearly see, from the above examples and evidence thereof, it is likely that global patient populations in MDS are vastly underestimated. For the sake of brevity, I can go over some of the numbers I’ve run on other countries based on what is known here in the US population at a later date. I’ll go into greater detail when discussing Imetelstat’s potential global marketplace – but for now:

“China with a population of 1.386 Billion could have an MDS patient population of 286,900* (US - 20.7 / 100,000) - that's almost 5x the US (60,000) and it's most likely much higher since pollution and non-registry play a large role in the increases in MDS patient populations found outside of "developed" nations.” - Kmall

*In my opinion the number in China is most likely 400,00 – 600,00 or greater when factoring in all of the above examples we have substantiated through recent findings.

**India with a population (1.38 Billion) almost equals that of China (1.386) Billion. It most likely mirrors China’s MDS patient population as well when factoring in the above discussion. These two nations combined could very well have an MDS patient population nearing 1 million or more. It’s easy to see why there has been a consistent uptick in revenue streams for those Pharmaceutical companies with approved Hematologic drugs quarter after quarter in “developed” nations – reeling in these “undeveloped” countries with astronomical potential would make a “paradigm shift” of epic proportions.

My final analysis on Thursdays CC will concentrate on data compiled with regards to revenue stream in 3 of the indications Imetelstat has in it’s sites – MDS, MF and AML. 2.5 Billion is starting to look more and more conservative in my view. Happy reading.

-Kmall

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