Slumping MRI market prompts Alliance to halt GI contrast agent effort

Drug firm sees potential in Johnson & Johnson alliance

MRI is becoming the Rodney Dangerfield of medical imaging. Manyfirms are scrambling to scale back investment in the technologyor are leaving the business altogether. The latest company tofold its MRI cards is Alliance Pharmaceutical, which is discontinuingpromotional efforts for Imagent GI, a perflubron-based oral contrastagent used to distinguish the bowel from adjacent organs.

Alliance made the decision to stop marketing Imagent GI becausesales of the product remained stagnant a year after its introduction(SCAN 8/25/93). Imagent GI produced revenue of less than $200,000for the San Diego company, according to executive vice presidentTed Roth. At the time the product was introduced, the potentialannual U.S. market for Imagent GI was estimated at $35 millionto $50 million.

The lack of reimbursement for oral MRI contrast hobbled ImagentGI, as did the sharp fall in MRI scan prices, which increasedthe cost of the product relative to the overall cost of a scan.As a result, many clinicians simply conducted abdominal scanswithout contrast to avoid the additional $200 charge.

The dramatic slide of the MRI market was a development thatno one in the industry predicted when Alliance filed Imagent GI'snew drug application (NDA) four years ago, according to Roth.

"It's difficult to remember what the environment was likeback in 1990. At that time we were looking at a growing MRI market,"Roth said. "As health-care reform and reimbursement issuesbecame more relevant, we saw things happening. But we obviouslyhad to continue to promote the application."

Alliance will continue to supply existing customers with ImagentGI through its distribution agreement with Picker Health CareProducts.

In addition to the change for Imagent GI, Alliance announcedit would suspend clinical development efforts for two CT contrastagents, Imagent BP and Imagent LN. Imagent BP and Imagent LN areperfluorochemical emulsions used for blood pool and lymph nodeimaging, respectively.

The catalyst for Alliance's cutbacks was a development relationshipthe company established with Johnson & Johnson last monththat held more promise for Alliance than the prospect of goingit alone in the contrast market. Johnson & Johnson wants touse the oxygen-carrying characteristics of Alliance's compoundsto develop other products, such as a temporary blood substitutefor use during surgery.

The cutbacks leave Alliance with one active imaging agent inits portfolio: Imagent US, an injectable ultrasound contrast agentfor assessing myocardial perfusion, cardiac function, vascularpatency and the detection of lesions in various organs. Allianceplans to file an investigational new drug application (IND) forImagent US by the end of this year and will start clinical trialsin early 1995.

While Alliance spent about $3 million this year marketing ImagentGI and developing Imagent BP and Imagent LN, Roth declined tocharacterize the company's experience with Imagent GI as a setback.The experience the firm gained in moving a perflubron-based agentthrough the Food and Drug Administration will pay off in the commercializationof other products the company is developing.

"It will be beneficial to our follow-on products thatare based on perflubron," Roth said. "We have a lotof the chemistry manufacturing controls, and many issues havebeen addressed, which should help in the review of our products."