AZ faces market-making task to capitalize on Movantik's edge in OIC

Congratulate AstraZeneca ($AZN) and Nektar Therapeutics. Their oral therapy for opioid-related constipation, Movantek, beat all rival pills to market. And if analysts are correct, that market lead will pay off big time.

Movantik is the first mu-opioid treatment approved specifically for opioid-induced constipation (OIC), and AstraZeneca and Nektar have blockbuster hopes for the drug. With market-watchers expecting that market to grow to $1.98 billion by 2017, those hopes may not be unfounded.

And with this first-to-OIC advantage, the two companies do have a clear edge in the market, Roth Capital Partners analyst Debjit Chattopadhyay told Reuters.

First off, AZ has the Big Pharma marketing prowess--and deep pockets--to give Movantik an all-out push into the field. It's not rival-free, but currently marketed competitors are either not approved for OIC, or, like Sucampo's Amitiza, work by another mechanism entirely. Others are over-the-counter meds that aren't effective enough.

Even if Salix Pharmaceuticals ($SLXP) nabs an OIC indication later this month for its mu-opioid med Relistor, AZ will still have the advantage: Relistor is an injectable, and patients tend to prefer pills. 

As for Cubist Pharmaceuticals' ($CBST) Entereg, another mu-opiod pill, it's not approved for OIC, either. It's restricted to hospital use only, and capped at 15 doses. Not to mention the fact that a late-stage study of the drug showed more heart attacks among Entereg patients--a stat that inspired an FDA advisory committee meeting last month for the entire mu-opioid class.

One potential snag: Relistor is already on the market, and AstraZeneca is figuring on a Movantik launch in the first half of next year, thanks to some Drug Enforcement Administration red tape. So, Salix will have some time to get doctors and patients onto the OIC use before AstraZeneca can actually deliver its pills.

AZ will also have some market-awareness hurdles to overcome. As Global Data noted in a market report late last year, doctors and patients aren't very savvy about OIC. Patients tend to use OTC drugs now, despite the fact that there's not much evidence they really work for this type of constipation.

"Improving diagnosis and increasing the awareness of new treatments are essential in boosting the drug-treatment rate for OIC," Global Data's Claire Gibson said in the report. "The potential success of OIC therapies ... will depend on extensive marketing."

- read the AstraZeneca release
- see the Reuters story

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