http://www.askanaddictioncounselor.com

Resilience – This generally refers to a person’s ability to cope with adversity, or the ability to bounce back from problems and setbacks. Research has shown resiliency to be a dynamic process.  Resilient individuals adapt to changing and unexpected events even under the duress of adversity. You can develop your own resilience by establishing good problem-solving skills, or by seeking help and building social support.  Fostering a belief that there are things you can do to manage your feelings and cope, and finding positive meaning in trauma, are other strategies for building your resilience.

Delayed gratification – Usually, people who can abstain from alcohol or drugs, or people who have managed to stay out of prison, have found ways to delay their gratification. People use chemicals to change the way they feel, so if you learn skills to act on your emotions in healthy ways, including offseting a need for immediate gratification, you can manage to fulfill your needs through avenues other than chemical use.

Volunteer work – My experience has shown me that volunteer work is a great way to feel better about yourself, develop a community of peers who share similar interests, and be of service to others.  If you want to raise your self-esteem, do things you’d be proud to tell other people.

Develop a mission or vision statement – Write yourself a paragraph that creates a framework for your sobriety.  My mission statement is as follows: My recovery is the single most important thing in my life.  Anything which jeopardizes this is eliminated.

Developing enthusiasm and interests outside of recovery – While getting and staying sober may not always be challenging, fascinating, and exciting, it shouldn’t be approached as a chore.  You can make it fun and enjoyable.  Explore new hobbies, interests, and opportunities for personal growth that are not directly applicable to staying sober.  Martial arts, horror films, model building, reading, exercise, cooking or pets are all viable options that could add color and interest to your life while enhancing your chances of recovery..

Habits – Develop good habits that support sobriety.  assign yourself time to “work” on your program, whether through meditation, journaling, time with a therapist, or exercise.  This is an investment in yourself and your success. Practice mindful awareness that you may not be able to control the outcome of a situation, and continue to practice these skills until you can use them with facility and ease.

Affirmations – Using affirmations can be quite helpful.  When you develop affirmations, make sure they’re worded simply, and in the present tense.  They should be specific, concrete, and personal to you.  Examples:  I attract all of the resources I need for comfortable recovery.  I can trust people.  I’m safe, and people want to be my friends.  I will nurture myself with these friendships.  I live in the present moment, and worry is a thing of the past.

Remember, recovery is a dynamic and fluid process, rather than a single event. Be mindful that, throughout your life, you will continue to learn skills to support you as a well-rounded, healthy person. Develop enthusiasm and add good habits to help you build and maintain a rock-solid program of recovery.

Article by Todd Branston - http://www.askanaddictioncounselor.com

Not so fast….

What you are likely experiencing is Post Acute Withdrawal Syndrome or PAWS.

PAWS consist of a set of impairments that occur immediately and at times simultaneously after the withdrawal from alcohol or other substances.  These impairments affect three distinct areas of functioning and last six to eighteen months from the last use of alcohol or drugs as your brain tries to regain homeostasis.

Some of these impairments include cognitive problems like racing thoughts, rigidity, numbing of emotions, difficulty with abstract thinking and poor attention span, all of which are prevalent during this time. Emotional difficulties include shame and guilt, as well as difficulties with resentments. Depression is common during this time and may lead to relapse as the addict is generally not prepared to deal with the wealth of emotions they experience. The dearth of emotions can lead people close to the addict to believe they might have relapsed.

While some counselors and organizations support 100% abstinence as the only way to resolve addictive behaviors, this approach tends to come across as a ‘one size fits all’ solution to dealing with these impairments.  While recovering from addictive behaviors it is remiss to not include an alternative approach without the mention of anti-craving medication as a treatment for PAWS.

Anti-craving medications may be appropriate for some individuals.  The use of medication does not represent a weakness in one’s ability to recover from addictive behaviors.  If anything, it should represent the idea that there is ‘another way’.

http://www.askanaddictioncounselor.com

There are various medications that have been found to have efficacy in dealing with alcohol/drug cravings:

Prazosin is often prescribed to deal with PTSD and night terrors. It has been found to be successful among Opiate addicts and individuals using Cocaine and Methamphetamine.

Acamprosate is used to treat Alcohol cravings.  In addition to its apparent ability to help patients refrain from drinking, evidence suggests that Acamprosate is neuroprotective. It has been shown that it can protect neurons from damage and death caused by the effects of alcohol withdrawal.

Naltrexone has been prescribed for Opiate cravings but is largely recommended as a treatment for alcohol abuse. It is also available in a monthly injectable form under the trade name of Vivitrol.

Baclofen and Topiramate have found therapeutic utility for Cocaine and Alcohol cravings.

While Methadone and Antabuse have found success in treating addictive disorders, they are not seen as anti-craving medications.  Antabuse is a deterrent to drinking as it prevents the breakdown of alcohol. Some 5–10 minutes after alcohol intake, a person will experience the effects of a severe hangover for a period of 30 minutes up to several hours.

Methadone is a synthetic Opioid and has been used as part of an Opiate substitution regimen. The drug has found success in supporting long-term Heroin addicts to wean off the drug.  In addition, Methadone has been used as a pain management protocol due to its long duration of action.  There is a fair amount of controversy around Methadone for Opiate substitution as the detractors point to length of time a patient uses the drug, suggesting that addicts are essentially substituting one drug for the next. Conversely The Addiction Recovery Institute points out the following benefits of Methadone Maintenance Treatment:

Reduced or stopped use of injection drugs

Reduced risk of overdose and of acquiring or transmitting diseases such as HIV, hepatitis B or C, bacterial infections, endocarditis, soft tissue infections, thrombophlebitis, tuberculosis, and STDs

Reduced mortality – the median death rate of opiate-dependent individuals in MMT is 30 percent of the rate of those not in MMT

Possible reduction in sexual risk behaviors, although evidence on this point is conflicting

Reduced criminal activity

Improved family, employment and pregnancy outcomes

It is important to reinforce the notion that an approach of 100% abstinence as a singular modality is not for everyone.  Medications can provide additional support but they should not be seen as a complete solution.  The goal of the medication should be to offset cravings and free up “emotional space” for the newly recovering person to add support in the form mutual aid groups, group or individual therapy, connection with a community of faith, exercise or involvement in an alcohol and drug treatment program.

Article written by Todd Branston - http://www.askanaddictioncounselor.com

And “We discern that if we can get rid of the hepatitis C, we can inhibit the spread of liver disease,” he said. “This means we can curb the progression of cirrhosis, we can prevent the advancement of cancer and also prevent the need for liver transplantation in a solid number of people”.

Incivek (telaprevir) was approved by the US Food and Drug Administration in May and is the aid medicine in a class of drugs called protease inhibitors to be approved to exchange blows hepatitis C The other drug, called Victrelis (boceprevir), was also approved in May. The support therapy for hepatitis C has been a syndicate of two drugs, pegylated-interferon and ribavirin, which are given for a year.

If protease inhibitors such as Incivek are added to the mix, the “viral cure” dress down improves and the healing take is reduced to six months, researchers found. Both reports were published in the June 23 online version of the New England Journal of Medicine.

In one study, a Phase 3 check known as ADVANCE, patients were randomly assigned to either a placebo or the curing in a double-blind study, which means that neither the patients nor the researchers understand who’s getting the cure and who’s getting a hoax treatment. This genre of ruminate on is considered the gold type for clinical research.

In the ADVANCE trial, 1088 patients with hepatitis C who had never been treated for the health were randomly assigned to lamppost psychotherapy for 48 weeks, or telaprevir combined with universal therapy for eight or for 12 weeks, followed by traditional therapy alone for a total number treatment time of either 24 or 48 weeks. The researchers found that 79 percent of those receiving Incivek for the longest while (24 weeks) had a “sustained response,” which basically means their hepatitis C was contained.

Among those receiving banner care, 44 percent had a unchanging response, the researchers noted. “We have entered a reborn time of group therapy for hepatitis C, which enables us to mend many more patients than we could before,” said principal researcher Dr Ira M Jacobson, from Weill Cornell Medical College in New York City.

Incivek needs to be given along with pegylated-interferon and ribavirin, Jacobson said. The researchers practised beginning on that Incivek singular reduces the up to date of the virus, but later the virus can become recalcitrant to the drug, he said.

For the approve study, called the REALIZE trial, 663 patients with hepatitis C who had failed yardstick analysis were divided into three groups. One troupe received Incivek profit principle therapy, another group was started on pegylated-interferon and ribavirin and then had Incivek added. The third gang received post therapy alone.

Here, the researchers found up to an 88 percent continual response in patients receiving Incivek, compared with a 24 percent interminable reply in the standard treatment group. “These drugs mirror a real milestone in the remedying of this disease,” said lead researcher Dr Stefan Zeuzem, a professor of c physic at JW Goethe University Hospital in Frankfurt, Germany. “There were very reduced treatment options in the past, but now many patients have admirable chances to be cured, even if they already have advanced disease,” he said.

Bernstein prominent that in the past, these patients could only be treated with more of the typical remedial programme for a longer age and the “cure” rate was only 10 percent. “Now you can look after these patients for six months with corn rates approaching 90 percent,” he said. “You are unquestionably offering expectation to a large number of patients”.

The side clobber of the medications include skin rashes, anemia, fatigue, itching, nausea, diarrhea, vomiting and mode changes. Some incidental crap were serious enough to cause a few participants to drop out, according to the study. Incivek, made by Vertex Pharmaceuticals Inc, is sold to wholesalers for $49200 for a four-week way of treatment, said Vertex spokeswomen Nikki Levy.

While both Incivek and Victrelis are outstanding breakthroughs in the treatment of hepatitis C, unripe drugs with even fewer sect goods and c shorter treatment times are in clinical trials, Bernstein said. Hepatitis C affects almost 4 million Americans, most of whom don’t conscious they’re infected rezberry ultra with virility ex pills. Often there are no symptoms, but it is the unrivalled cause of liver transplantation in the United States and is linked to as many as 12000 deaths a year, the researchers say.

We are talking about the recent announcements made by big players like Johnson & Johnson (JNJ), Bristol-Myers Squibb (BMY) and Gilead Sciences, Inc. (GILD). All three companies have made it clear they want a piece of the HCV market pie.

Johnson & Johnson’s Tibotec Pharmaceuticals and Bristol-Myers Squibb recently announced that they have decided to join forces for the development of Bristol-Myers’ daclatasvir (BMS-790052) in combination with Tibotec’s TMC435, for the treatment of chronic HCV. What the partners are aiming to do is create an oral once-daily interferon-free cocktail treatment for HCV patients.

Bristol-Myers and Johnson & Johnson’s announcement comes on the heels of Gilead’s announcement regarding its intention to buy Pharmasset, Inc. (VRUS), a company focused on developing HCV treatments. We think the main attraction for Gilead in this $11 billion deal is Pharmasset’s HCV pipeline. Lead candidate PSI-7977 is currently in two phase III studies, with a third phase III study scheduled to commence in the first half of 2012. Successful development could lead to US approval in 2014 thereby making Gilead a front-runner in the oral once-daily interferon-free cocktail treatment HCV market.

We note that both TMC435 and daclatasvir are being evaluated separately in combination with Pharmasset’s PSI-7977.

The Allure of the HCV Market

It is estimated that about 170 million people suffer from HCV infection around the world. However, the treated population is much lower. In major markets like the US, EU, Japan, Australia, Turkey, Canada, etc. only 200,000 HCV patients out of a total of more than 12 million are estimated to receive treatment each year. This means a huge number of HCV patients go untreated, leaving the field open for new treatments.

Secondly, the current standard of care comes with several side effects which make it difficult for patients to remain on treatment. A 48-week course of both peg-interferon (peg-INF – weekly injections) and ribavirin (RBV – oral drug), are the standard treatment for genotype 1 HCV infection. However, this treatment regimen is associated with significant side-effects like fatigue, flu-like symptoms, rash, depression and anemia.

With a large number of HCV patients failing to achieve a sustained viral response (SVR) on the current standard of care, there are several patients who would be open to treatment with new and potentially more effective therapies.

These factors have made the HCV market an attractive commercial opportunity for pharma and biotech companies. Victrelis and Incivek are examples of the changing treatment regimen in the HCV market. Both are protease inhibitors which when added to the standard of care reduce the treatment period and also improve the treatment outcome. However, both need to be administered with peg-IFN and RBV – this leaves the path open for the introduction of treatments with fewer side effects.

Cocktail Therapy – The Next Big Thing in HCV

Companies like Johnson & Johnson and Gilead are trying to develop the next crop of drugs, which are expected to change the treatment paradigm for HCV patients by providing them with all-oral treatment regimens. The aim is to develop a treatment which does not require the administration of interferon, thereby doing away with a whole range of side effects. The treatment duration will also be shorter.

Treatments being developed include HCV polymerase inhibitors and HCV NS5A inhibitors. The future HCV market will most likely consist of cocktail treatment regimens developed by combining different oral treatments.

Vertex Pharma has also recognized the need to continually evolve the HCV treatment pattern and is developing an all-oral combination of VX-222 (a polymerase inhibitor) and Incivek without peg-IFN.

Who Will Win the Race?

With several companies pursuing cocktail therapies for HCV, it will be interesting to see which of these companies will be the first to hit the market with a new treatment option. Currently, it looks like Gilead might be the front-runner assuming the Pharmasset acquisition goes through.

Want more from Zacks Equity Research? Subscribe to the free Profit from the Pros newsletter: http://at.zacks.com/?id=5515.

About Zacks Equity Research

Zacks Equity Research provides the best of quantitative and qualitative analysis to help investors know what stocks to buy and which to sell for the long-term.

Continuous coverage is provided for a universe of 1,150 publicly traded stocks. Our analysts are organized by industry which gives them keen insights to developments that affect company profits and stock performance. Recommendations and target prices are six-month time horizons.

Zacks “Profit from the Pros” e-mail newsletter provides highlights of the latest analysis from Zacks Equity Research. Subscribe to this free newsletter today: http://at.zacks.com/?id=5517

About Zacks

Zacks.com is a property of Zacks Investment Research, Inc., which was formed in 1978 by Leon Zacks. As a PhD from MIT Len knew he could find patterns in stock market data that would lead to superior investment results. Amongst his many accomplishments was the formation of his proprietary stock picking system; the Zacks Rank, which continues to outperform the market by nearly a 3 to 1 margin. The best way to unlock the profitable stock recommendations and market insights of Zacks Investment Research is through our free daily email newsletter; Profit from the Pros. In short, it’s your steady flow of Profitable ideas GUARANTEED to be worth your time! Register for your free subscription to Profit from the Pros at http://at.zacks.com/?id=5518.

As pharma troops further into biotech territory, an area often characterized by smaller patient pools and more limited sales, maybe there should be a lesser threshold of commercial success.

Not so fast, says Ben Weintraub, PhD, director of research at Wolters Kluwer inThought. Exhibit A, he says, is Vertex’s drug for treating hepatitis C virus, Incivek. Since jumping from the pages of our Pipeline 2011 report to a May approval by the FDA, Incivek is well on its way to making history—reaching a billion dollars in sales by year’s end would make it the fastest new product launch on record.

“The idea that the age of the blockbuster is over is definitely not true,” Weintraub asserts. While Incivek is no Lipitor, it “still shows that a new drug can get taken up and used, change the standard of care, and make a lot of money.”

Huge, chronic markets like diabetes or cardiovascular disease are no longer the only tickets to success. “Now, what you need to become a blockbuster,” he says, “is a specialty drug, one that’s expensive—to offset the smaller treatment population—but one that fills a significant unmet need.”

Among potential blockbusters set to launch in the next few years, several are speciality drugs. In hepatitis C, we may see another one.

Drug developers are getting closer to an all-oral HCV regimen that eliminates the need for injected interferon. The first of these is expected to reach market in 2015. Until then, Boehringer Ingelheim’s BI-201335 could make inroads on Incivek and Merck’s Victrelis. On similar lines, some are looking for Biogen Idec’s BG-12 to unseat Novartis’ Gilenya as the preferred oral multiple sclerosis drug.

Among oral small molecules, Pfizer’s tofacitinib and AstraZeneca/Rigel’s fostamatinib have their sights set on challenging injected biologics in rheumatoid arthritis. There are also expectations that the novel oral anticoagulant Eliquis (Bristol-Myers Squibb/Pfizer) could be the third such agent approved and make a serious bid for cardiologists’ Rx pads, although inexpensive warfarin could curb sales.

In addition to the infectious disease, neurology, rheumatology and cardiovascular sectors, this report dives into oncology, where the big story is the recent slate of personalized medicine approvals: BMS’s Yervoy, Pfizer’s Xalkori and Roche/Plexxikon’s Zelboraf. In these pages you’ll read about other biologics being developed for targeted lines of tumor treatment. Metabolic and orphan therapies, plus respiratory and women’s health, are highlighted in the report, too.

Consistent with our methodology the last several years, top picks are based on consultation with Wolters Kluwer inThought, Adis R&D Insight, GfK HealthCare and other experts. Each profile has a snapshot of safety and efficacy data vs. the standard of care and, where available, the estimated month of approval, plus a quick way to gauge the likelihood of an FDA OK called the inThought Approvability Index (anything above 50% stands a good chance). Rounding out the report are analyst comments, revenue forecasts and lists of other key products.

Pfizer is forging ahead with a slimmer R&D group and a pipeline that features so-called miniblockbusters and specialty drugs that could command top dollar. Two of the company’s best pipeline prospects are the rheumatoid arthritis pill called tofacitinib and the blood thinner Eliquis, both of which are expected to generate more than $1 billion in sales if approved. And Sanford C. Bernstein analyst told Bloomberg that the company aims to bring in $4 billion from those two drugs as well as the recently approved Xalkori and Prevnar by 2014.

Sign up for our FREE newsletter for more news like this sent to your inbox!

Clearly, there’s no one drug in the company’s pipeline that is expected to replace Lipitor, and health payers are demanding that new drugs provide better results to patients than previous products. Pfizer and its industry rivals are therefore forced to seek out niche areas of medical need in which new drugs can make a big impact–and, believe it or not, provide innovative therapies. Pfizer has Xalkori as a poster child for personalized treatments with high value to specific patients, as the drug extends survival for patients with non-small cell lung cancer, but only for the 3%-5% of patients whose tumors are ALK-positive.

At the same time, there are still big markets to pursue. Some of the big ones include Alzheimer’s disease, for which there is a lack of good treatments, and the rapidly growing market for drugs against Hepatitis C virus. However, the shelf lives of new blockbusters might be shorter than previous big-sellers like Lipitor, as multiple drugs against the same targets compete and beat out others for market share. “We won’t see drugs with the longevity of Lipitor,” Ken Kaitin, director of the Tufts Center for the Study of Drug Development, told Nature News. “We’ll see drugs that sporadically reach very high levels of revenue, and then come down.”

This could become the case with the new crop of drugs for hepatitis C, including Vertex Pharmaceutical’s ($VRTX) recently approved drug Incivek, which face potential competition from interferon-free treatments with fewer side effects in just a few years. This puts a lot of pressure on R&D groups to stay productive, and should make for an exciting decade in the biopharma industry.

Acquisition of Pharmasset

Gilead Sciences (GILD) announced its intent to acquire Pharmasset (VRUS) for a whopping $11 billion on Monday morning. The deal has led many analysts and investors to question if Gilead overpaid for the deal. I think the deal is a great long-term play for the company and actually could present a buying opportunity of shares, which were down sharply after the announcement. Shares were up around five percent the following day after the announcement. Gilead will now be a large player in the HIV and Hepatitis markets.

Pharmasset has no drugs on the market, which is the biggest reason why people question the valuation. Drug candidate PSI-7977 appears to show enough promise that other companies were nibbling at acquiring the company. Gilead is confident in its acquisition and is funding the deal through cash and $6 billion in debt it is taking on. Hepatitis C is being targeted by this drug and it could actually save many Americans from the life threatening liver damage that is usually caused by the disease and leads to many liver transplants. The drug is expected to be filed with the Food and Drug Administration in 2014. Pharmasset owned the worldwide rights to the drug so Gilead will take full control and will not have to worry about licensing or royalty payments. Gilead now will be the leader in the race to find an all oral drug for the treatment of Hepatitis C.

Why the Acquisition and Hefty Premium

Gilead presented a slide show on its website shortly after the announcement to acquire Pharmasset. Gilead reconfirmed its goal of creating the best Hepatitis C drug, which would be determined by some of the following:

• Taken Once Daily
• Manageable Side Effects
• Higher Cure Rates Than Current Drugs on the Market
• Increased Treatments With a New Drug

Gilead has recognized that a combination of two or more drugs may be needed to create this super Hepatitis C drug. This is where I believe that Gilead’s acquisition will ultimately pay off. Gilead has combined several of its own drugs with products of other companies to create better acting and more effective drugs for patients.

Competition in Hepatitis C Market

Several other Hepatitis C drugs have popped up on the market recently. Victrelis is a drug owned by Merck (MRK), acquired through its acquisition of Schering Plough. The drug has so far been a disappointment as it only brought in $31 million of revenue in the third quarter reported on October 31, for Merck. Incivek, a drug owned by Vertex Pharmaceuticals (VRTX), on the other hand posted sales of $419 million in the past quarter. Analysts have already been lowering price targets of VRTX because of the likely competition from PS-7977 pending approval. Vertex will enjoy a couple of years of dominating market share before the competing drug enters the market. Annual sales could hit $2 to $3 billion for Vertex. Merck on the other hand is playing second fiddle and is likely to never see blockbuster status with its Hepatitis C drug.

Gilead’s Biggest Acquisitions

Gilead has a long history of acquiring other drug companies as many large drug companies do. Highlights include:

• 1999 Nexstar Pharmaceuticals – Gained two drugs through the acquisition. One, Ambisome, is still a marketed drug by Gilead. Deal seemed to be made more for the company’s intent on expanding in Europe.
• 2003 Triangle Pharmaceuticals – Emtriva, now a part of two Gilead drugs, was gained through this $464 million acquisition. Atripla and Truvada both use the component emtricitabine, a former Triangle product.
• 2006 Corrus Pharma – Has a current drug in Gilead’s pipeline aimed at treating Cystic Fibrosis.
• 2006 Myogen – Myogen was the most expensive acquisition previous to Pharmasset coming in at $2.5 billion. This has also been one of the most important and successful acquisitions made by Gilead as it brought three drugs, two marketed, and one currently sold by Gilead to the company.
• 2009 CV Therapeutics – Billion dollar purchase helped strengthen and diversify Gilead’s pool of drugs as it gained two drugs aimed at cardiovascular diseases.

Several other million dollar deals were made by Gilead over the last eight years. Gilead has made many of its acquisitions to strengthen its own technology and combine existing drugs with new ones.

Gilead’s Products

Gilead remains the market leader in drugs that treat the HIV virus. Its marketed products in the HIV market are:

Atripla is marketed with Bristol Myers Squibb (BMY) after its approval in 2006. The drug treats HIV and will lose patent expiration in 2021.

Complera is one of Gilead’s newest drugs on the market. It was approved by the FDA in August of 2011, and is co-marketed with Johnson and Johnson (JNJ).

Emtriva was approved in 2003 and will expire in 2021.

Truvada treats HIV and is one of Gilead’s top selling drugs. It was approved in 2004 and will lose its patent protection in 2021.

Viread treats Hepatitis B and HIV viruses. The drug was the first successfully launched HIV drug in 2001 by Gilead. The drug, which is a huge seller for Gilead, will lose patent protection in 2017.

Gilead has drugs in several other fields that compete with numerous other large drug companies. The other drugs currently on the market are:

Ambisome treats infections like fungal, meningitis, and Cryptococcus. The drug was approved in 1997 and will lose patent protection in 2016. The marketing partner on the drug is Astellas Pharma.

Cayston is Gilead’s cystic fibrosis drug that was approved in 2010. The drug has exclusive patent protection until 2021. Gilead markets the drug on its own and maintains all revenue from the drug.

Hepsera treats Hepatitis B and is owned and marketed by Gilead. The drug was approved in 2002 and its patent expires in 2014.

Letairis has since 2007 treated Pulmonary Hypertension. The drug is co-marketed with GlasxoSmithKline (GSK) and loses patent protection in 2015.

Lexiscan is a cardiovascular drug marketed with Astellas Pharma and it will lose patent protection in 2019.

Macugen is an age-related macular degeneration drug first approved in 2004, which is shared with Pfizer (PFE) and will lose patent protection in 2017.

Ranexa treats chest pain and will lose patent protection in 2019. The drug is co-marketed with Swiss drug company Roche.

Tamiflu treats the influenza virus as an oral capsule. The drug, which loses its patent protection in 2016, is licensed to Roche.

Vistide treats Cytomegalovirus and also certain eye problems involving the retina. The drug was founded in 1996 and has since lost its patent protection.

Gilead’s Pipeline

Gilead has twenty drugs listed on its site in current phases of trial. The drugs target HIV, Hepatitis C, numerous Cardiovascular diseases, Diabetes, Leukemia, Non-Hodgkin’s Lymphoma, and other diseases. Like many other large drug companies, Gilead has kept a strong pipeline targeting some of the biggest diseases affecting the world today. Three drugs targeting HIV are in Phase III trials currently. The Pharmasset acquisition will improve the company’s pipeline as it focuses on becoming a large player in the Hepatitis C market. Gilead will likely test several of its own Hepatitis drugs with Pharmasset products to create dual drugs much like it has with its HIV drugs.

The most important drug for Gilead in my opinion is known as the Quad. The drug combines Gilead’s own products and will help cut part of its revenue share with other marketing partners. The drug has held up well in trials. The drug will be brought in front of the FDA in 2012 and could be a substantial revenue earner for Gilead. The Quad drug is cutting down on symptoms from Gilead’s Atripla including dizziness, insomnia and depression. There are two trials testing Gilead drugs together in the Quad trials. Atripla had sales of $2.9 billion over the last year. However a portion of that revenue is given to Bristol Myers Squibb for its contribution to the drug. The approval of the quad pill could provide a nice bump to the share price in 2012.

Gilead’s Current Sales

Gilead is the leader in the HIV drug market and has shown its dominance. From the slide show presentation after the Pharmasset announcement it listed trailing twelve month revenue at $7.4 billion. The total market for HIV drugs is currently $13 billion so Gilead controls 50% of this blockbuster medical category. In the last fiscal year Gilead had earnings per share of $3.32 based on earnings of $2.9 billion.

Analysts call for earnings of $4.37 for the next fiscal year. With a closing share price of $39.28 on Friday, the price-to-earnings ratio is less than nine. According to Yahoo Finance, over 91% of the shares are currently held by institutions and mutual funds. More than 900 funds hold shares of Gilead as it represents one of the best plays on the healthcare and drugs industry.

Analyst Upgrades

Several days after the acquisition of Pharmasset was announced, analysts have upgraded shares. Citigroup and Bank of America both upgraded the shares after revaluating. Bank of America said that the company’s Hepatitis C program could some day be worth $15 to $30 billion. Gilead currently has a market capitalization of just under $30 billion so this deal could clearly define the company for the future.

My Share Valuation

I think the buyout of Pharmasset is a great purchase for Gilead. Gilead has made great use of drugs acquired through pipelines of companies it has bought out. Gilead absolutely owns the HIV drug market and the deal should help insure it gets a large portion of the Hepatitis C drug market in the future as well. For the coming year shares should trade closer to 12 times earnings, which would represent a share price of $52.44. The approval of the Quad drug as well as earnings announcements could power shares past $60. I think long term the company could double its market capitalization to $60 billion with its marketed HIV drugs and several Hepatitis C drugs on the market. I think shares would be a great purchase for an IRA as a bet on the company for the future.

Disclosure: I have no positions in any stocks mentioned, but may initiate a long position in GILD over the next 72 hours.

But one of the reasons for the large number of patients could be the downfall for hepatitis C drugmakers.

Hepatitis C is a chronic disease that’s slow to progress. It eventually causes liver problems including scarring of the liver or liver cancer, but that’s often years after the initial infection. In fact, many of those 3.2 million Americans don’t even know they’re infected.

The slow progression of the disease allowed doctors to put off treatment, called warehousing, and wait for Merck‘s (NYSE: MRK  ) Victrelis and Vertex Pharmaceuticals‘ (Nasdaq: VRTX  ) Incivek to work their way through the drug-development process. The previous generation of treatment options — Merck’s PegIntron and Roche‘s Pegasys — cure only around half of the patients and had nasty side effects that weren’t all that appealing, considering the flip-of-a-coin chance at a cure.

Warehousing 2.0
Clearly, many doctors and their patients have decided that they’ve waited enough. Incivek is off to a blustering start, registering $420 million in sales during its first full quarter on the market.

But Incivek isn’t perfect. It still requires patients to take PegIngron or Pegasys, albeit for a shorter duration of time than it was used when the drugs were taken on their own. Multiple companies are going after an interferon-free regimen that would be taken orally.

Pharmasset, which is being bought by Gilead Sciences (Nasdaq: GILD  ) , has a hepatitis C drug candidate, PSI-7977, which looks good so far as an interferon-free treatment. Gilead has other hepatitis C drug candidates it’s developing that could be used in combination with PSI-7977 if it doesn’t work on its own. And there are plenty of other drugmakers, including Achillion (Nasdaq: ACHN  ) , Inhibitex (Nasdaq: INHX  ) , Vertex, Merck, Johnson & Johnson, and Bristol-Myers Squibb (NYSE: BMY  ) , developing other hepatitis C drugs that they hope can be part of an interferon-free cocktail.

It seems entirely possible that doctors will continue warehousing all but the most-progressed patients until there’s an interferon-free treatment regimen that works as well as or better than the current standard of care. If that occurs, the peak sales of Incivek would be substantially diminished.

And then …
If patients are going to wait for all-oral interferon-free regimens, why not wait until the drugs become generic and save some money? Granted, it’ll take a while to get to that stage; patients being seen by doctors right now aren’t likely to be thinking that way, but it seems entirely possible that the effective patent life of hepatitis C drugs could be cut short by a few years as patients considering treatment within a few years of patent expiration might just elect to wait.

And of course, at some point, the hepatitis C market will begin to shrink. Unlike HIV drugs that aren’t really a cure, hepatitis C drugs rid the patients of the virus, so as more patients are cured, the number of newly infected individuals should drop. How far in the future the drop begins will be dictated by how quickly patients get on medication, so the faster the ramp-up in sales, the sooner sales will drop off.

Far enough in the future?
That’s what every hepatitis C investor has to ask: Can you capture the value now and get out before things eventually blow up?

At this point, investors seem to be ignoring the future — Pharmasset is up more than 500% over the last year — but that seems a little risky for long-term investors. If you’re going to invest in the space for any reasonable length of time, consider a company that has its hand in more than one market. Vertex, for instance, is developing drugs for cystic fibrosis, and it’s on sale.

And if you want to learn of a disruptive technology that isn’t concerned about rapid obsolescence, download a copy of The Motley Fool’s special free report, “The Next Trillion Dollar Revolution.” Don’t miss your chance to invest in the company at the heart of a massive paradigm shift.