Earlier this year, researchers reported impressive results for a treatment that offered a potential cure for intractable cases of hepatitis C. But now, millions of patients waiting for such a breakthrough may never get it.

The story of how the promising therapy got stalled despite positive research illustrates a little-acknowledged truism in the pharmaceutical industry: Sometimes drugs die not because they don’t work or are unsafe, but because they don’t make business sense.

The hepatitis C treatment paired a pill from Bristol-Myers Squibb Co. with another from a biotech called Pharmasset under an agreement struck last year. After the successful early research, Bristol was “very keen” to quickly move into final testing, according to Douglas Manion, a Bristol drug-development official. But by that time, things had changed: Pharmasset had been bought by Bristol’s rival Gilead Sciences Inc. And Gilead “declined to collaborate,” said Dr. Manion.

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