Portola Pharmaceuticals Inc's Anticoagulant Gamechangers

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In a few years, Portola Pharmaceuticals (NASDAQ: PTLA  ) might be selling a leading thrombosis prophylactic, as well as a much needed antidote for the medication. In an effort to bring its antidote to the market quickly, the company may also benefit Bristol-Myers Squibb (NYSE: BMY  ) ,Pfizer (NYSE: PFE  ) , Bayer AG, and Johnson & Johnson. Lets take a look at the company's experimental drugs and see how this scenario could play out.

A simpler anticoagulant
Portola Pharmaceuticals may soon turn the world of blood thinners on its head. Less than a year after its IPO, the company has an oral once-daily inhibitor of Factor Xa, named betrixaban, in a pivotal Phase 3 trial for the prevention of blood clots known as venous thromboembolisms (VBTs).

After various types of surgery, patients are typically given enoxaparin as an injection in a hospital setting. The drug itself is safe, but keeping it at an effective level in the bloodstream is difficult. Due to this difficulty, the therapy is typically stopped when they're sent home. Far too often, patients then develop blood clots that pose serious health risks and require rehospitalization.

Betrixaban is a pill that can be taken once daily to continue prevention of VBTs without extensive monitoring. So far, it appears to maintain effective levels in the bloodstream without going overboard. Payers often penalize hospitals if patients are rehospitalized shortly after their discharge. If approved, betrixaban is likely to be very widely prescribed, saving health care providers a bundle.

Inhibition on... inhibition off
Trying to prevent blood clots can create as many problems as it solves. Patients are often treated with Factor Xa inhibitors, like betrixaban, suffer uncontrolled bleeding episodes or require emergency surgery. In either case, the ability to switch off the inhibition of clotting factors can save a life. Unfortunately, physicians do not have an effective switch, but Portola is developing the first.

Portola's most groundbreaking candidate is andexanet alfa, a recombinant protein designed to reverse the anticoagulant activity of Factor Xa inhibitors. Last May, this therapy became the first to...

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