Well, as a comment to Tuesday's post mentioned, no sooner do I talk about the antifungal market than Pfizer turns around and buys a company with a promising antifungal drug. Vicuron has concentrated on antiinfectives in general, which has been a rough place to be over the last ten years or so. Good ideas are hard to find, and if you come up with an amazing new antibiotic, you can expect to see its use restricted as much as possible. And rightly so, in hopes of delaying the onset of resistance. That's good medical practice, but it does tend to put a kink in the sales figures.

Pfizer's deal makes a lot of sense. Their last big new antibiotic ran into trouble a few years ago over side effects: Trovan (alatrofloxacin), another fluoroquinolone. They acquired Zyvox (linezolid), the first oxazolidinone antibiotic, when they purchased Pharmacia/Upjohn, and they still sell an awful lot of Zithromax (azithromycin). But I don't believe that there was much coming along in their antiinfectives portfolio, and they have immediate problems to be fixed. Last summer, Pfizer lost patent protection for Diflucan (fluconazole, which I mentioned the other day), and the patent for azithromycin expires later this year.

The Pfizer deal-makers have been on hiatus recently, but they'll probably keep busy for a while now, because the company is facing even more patent expirations over the next few years. As the clock keeps ticking, Pfizer will probably be forced to go out and buy things before their mighty marketing machine starts sucking air. They're already talking about cutting costs and head count, and I've heard from inside the company that some people there are uneasy about the future. And perhaps they should be - no one's ever tried to have a drug company as big as Pfizer before, and it's not for sure that it's such a great idea. Not everything scales up. Research productivity, for example, may actually have a negative correlation with size.

I've wondered, loudly, for years how they're going to manage. Nothing's made me change my mind. An antibiotic and an antifungal will help, but Pfizer's going to need a lot, lot more.