| Last December, Goldman Sachs looked into its crystal ball and made a grand proclamation: 2019 would be "The Year of NASH." The bank's analysts were betting big on drugs for a liver disease driven by obesity that could be lurking undetected in millions of people. The world's largest pharmaceutical companies, including Gilead, Pfizer and Bristol-Myers, were investing in their own treatments, but biotechs like Intercept appeared to be outrunning the competition in a race to bring the first drug to market.
One thing's now clear: This certainly wasn't the Year of NASH. Gilead said in February its top candidate had failed, and it delivered more disappointing news about its combo treatments this week. Small fatty-liver drugmakers once thought to be takeout targets have yet to be scooped up by those with deep pockets. Their stocks have whipsawed at the whims of investors who remain skeptical about the commercial prospects of a disease that's difficult to diagnose and a drug that'll be hard to reimburse. Looking ahead, Intercept's greatest challenge won't be bringing a drug to market. It'll be marketing it. Insurers are looking to limit their exposure to new, expensive therapies for chronic disease. And in this case, the U.S. health system doesn't yet have the proper infrastructure for treatment. "There's a burden of being the leader, the pioneer," said Mark Pruzanski, Intercept's founder and chief executive, in an interview. Big Pharma has "clear interest" and will be watching how the company fares, he said. So, could 2020 be the Year of NASH? Could any?—Riley Griffin Here's what else we're watching: Legal limbo. The fate of Obamacare is unclear again after a federal court found a key piece of the law unconstitutional, but then sent the case back to a lower court. For patients, millions will stay covered—for now. Split decisions. Regulators gave the all-clear to the closely watched Roche-Spark Therapeutics deal, but nixed Illumina's purchase of a close rival, saying it would stifle competition in consumer DNA. Heart helper. Amarin won expanded approval for its fish-oil-based heart therapy, a clearance which could help make the drug a blockbuster. The decision could also make Amarin a deal target for bigger pharma rivals. Listen up. Want to hear more from Prognosis? Then listen to our podcast, which has explored superbugs, what we share when we share our medical data online, and more. Download it here on Apple devices, and here on Android.  Got this newsletter forwarded to you? Sign up to get it every Thursday by clicking here.
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