Upsets, buzzer-beaters and chalk: It's the #FierceMadness Sweet 16

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After a rollercoaster Round 3, we're down to 16 remaining contenders for the Best Drug Name title--and with a certain heavyweight knocked out of contention (cough Belsomra cough), this tournament's now wide open. If any of the rest of you feel like pooling your votes to propel your favorite med into the regional finals, go for it--this championship is yours for the taking.

You have through the end of the weekend before we close the polls and tally up the Round 4 votes.

Godspeed! (And don't forget to keep the comments and #FierceMadness tweets coming.)

-- Carly Helfand (email | Twitter) and Damian Garde (email | Twitter)

Anti-infective Region

It's all Cubist over here in the anti-infective region, where both Zerbaxa--which "sounds like a good name for a women's prison somewhere outside Zagreb"--and Sivextro brought home third-round victories. But the regional semis will be no walk in the park for the pair, which will take on Cresemba and Sovaldi, respectively. Meanwhile, this week we bade farewell to contenders such as the ever-literal Ragwitek, and the antifungal Luzu, which one of you thought "sounded too much like an Internet TV channel." As another pointed out, "it's got 'lose' in the name, therefore it can't win." The voters have spoken.

No. 1 Zerbaxa vs. No. 13 Cresemba

Zerbaxa
Maker: Merck ($MRK)
Indication: Bacterial infection
Sounds like: A flowering plant species you shouldn't touch if you find it in the woods

Cresemba
Maker: Astellas
Indication: Fungal infection
Sounds like: A minor moon of Saturn

No. 6 Sivextro vs. No. 7 Sovaldi

Sivextro
Maker: Merck
Indication: Bacterial infection
Sounds like: A ruthless Roman emperor who murdered his way to the top

Sovaldi
Maker: Gilead Sciences ($GILD)
Indication: Hepatitis C
Sounds like: A celebrated opera composer

Cardiometabolic and Respiratory Region 

Whoever lamented, "I just really want Afrezza to lose" last week will be disappointed with Round 3's results. The med triumphed over Zontivity, leaving just one "-ity" name--Trulicity--alive in the Cardiometabolic and Respiratory bracket (which we may as well just rename Diabetes). One voter "lost a bundle at the Toujeo table" in Vegas just as the med bowed out to Invokana, who may or may not have been "married to Donald Trump at one time." Meanwhile, with a big win over Tanzeum, Saxenda is the lone 16-seed still alive after three rounds of play.

No. 16 Saxenda vs. No. 5 Invokana

Saxenda
Makers: Novo Nordisk ($NVO)
Indication: Obesity
Sounds like: A distant relative of our coworker Varun

Invokana
Maker: Johnson & Johnson ($JNJ)
Indication: Diabetes
Sounds like: The hostess at a pagan ceremony

No. 6 Trulicity vs. No. 10 Afrezza

Trulicity
Maker: Eli Lilly ($LLY)
Indication: Diabetes
Sounds like: A truly next-generation dating app

Afrezza
Makers: MannKind ($MNKD) and Sanofi ($SNY)
Indication: Diabetes
Sounds like: A pasta special at Olive Garden

Oncology Region

After a bracket-busting Round 2, the wild Oncology Region lived up to its reputation, with top seed Zydelig--pegged by one reader as "a great band that played just off Bourbon Street in the Quarter"--falling to Imbruvica. No. 2 Blincyto advanced to the round of 16, perhaps due to its similarity to something "served in many Jewish delis with a little schmear," according to the same voter. Another wondered whether, as "we've entered the lunar year of the ram," it might be Cyramza's time to shine, but it was Ibrance ("youbrance, don't we allbrance?" asked a third) that emerged victorious in the 4-12 matchup. Now the omnibrance contender will square off with Imbruvica while Blincyto faces a dogged Keytruda--or "Key-true-dat!" per a reader nickname that hopefully doesn't catch on--in what's sure to be a thrilling prelude to the quarterfinals. (Except for the person who commented "I don't like any of these!" He or she is probably not going to be thrilled.)

No. 9 Imbruvica vs. No. 4 Ibrance

Imbruvica
Makers: Johnson & Johnson and Pharmacyclics ($PCYC)
Indication: Leukemia
Sounds like: A high-end camera manufacturer

Ibrance
Maker: Pfizer ($PFE)
Indication: Breast cancer
Sounds like: A trendy self-help program that might be a pyramid scheme

No. 11 Keytruda vs. No. 2 Blincyto

Keytruda
Maker: Merck
Indication: Melanoma
Sounds like: An unwanted visitor impervious to locks

Blincyto
Maker: Amgen ($AMGN)
Indication: Leukemia
Sounds like: A Russian-fusion food truck that's, like, really hot right now

CNS and Specialty Region

Coming into Round 3 in the CNS and Specialty Region, Belsomra was a speeding juggernaut, crushing Rytary 328-74 and looking destined for a shot at the crown. But that, as they say, is why they play the games--or fill out the Google forms, or whatever the appropriate phrasing might be for an Internet tournament. The point is, No. 2 Belsomra lost, narrowly, to No. 10 Hysingla, a surging contender that "sounds like a wrestling move," according to one supporter. Now it'll take on a bona fide Cinderella in Cosentyx, which upended Tecfidera to keep its run going. Elsewhere in the bracket, Eloctate did not, as one reader predicted, "'loc' in a victory" but instead fell to Movantik, a constipation medicine whose name-indication interplay brought out the inner third-grader in more than a few commenters. And, to no one's surprise, top seed Vimizim rolled over No. 9 Natpara, eliciting a spirited "Vim zim vimizim--kapoof!" from a reader, either referencing the cringe-inducing cartoon Johnny Quest or simply taking this absurd exercise to its logical conclusion: gibberish. Anyway, vote!

No. 1 Vimizim vs. No. 5 Movantik

Vimizim
Maker: BioMarin ($BMRN)
Indication: Morquio A syndrome
Sounds like: A crossed-out idea from the brainstorming session that led to Wreckx-n-Effect's biggest hit

Movantik
Maker: AstraZeneca ($AZN)
Indication: Opioid-induced constipation
Sounds like: A soccer club in Germany's Bundesliga, short for Verein für Leibesübungen Movantik 96

No. 11 Cosentyx vs. No. 10 Hysingla

Cosentyx
Maker: Novartis ($NVS)
Indication: Psoriasis
Sounds like: A friendly prehistoric bird

Hysingla
Maker: Purdue Pharma
Indication: Chronic pain
Sounds like: How first basemen greet runners

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