Pfizer Inc. / Vicuron Pharmaceuticals Inc.

Invasive Candidiasis / Candidemia

25K US cases/yr

Disease Overview

Invasive candidiasis is a serious bloodstream and deep-tissue infection caused by Candida species, most often striking ICU patients, surgical patients, and the immunocompromised. It is hard to treat because the fungus colonizes catheters and devices, and azole resistance is rising, leading to delayed effective therapy and high mortality.

Competitive Landscape

By the time Pfizer closed the Vicuron deal in September 2005, the echinocandin antifungal class was emerging as the new standard for invasive candidiasis. Merck's Cancidas (caspofungin), approved in 2001, was the first echinocandin and held the market; Astellas' Mycamine (micafungin) followed in March 2005. Vicuron's anidulafungin, FDA-approved February 2006 as Eraxis, became the third echinocandin, differentiated by linear non-hepatic elimination (spontaneous chemical degradation) and no dose adjustments with cyclosporine, tacrolimus, or voriconazole, making it favorable for transplant and ICU combination therapy. Older azoles like fluconazole (Diflucan, by then generic) remained widely used but Vicuron's pivotal Phase III had shown anidulafungin superior to fluconazole in candidemia/invasive candidiasis. The Pfizer deal gave a global commercial sales force the asset needed to compete head-on with Merck and Astellas in hospital antifungal formularies, while Pfizer's parallel acquisition of dalbavancin extended its anti-infective franchise into Gram-positive skin infections.