Regarding karxt

I found out that the individual parts of karxt are actually old medicines, why is it only until now we use them together?

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Because of some gastroentestinal side effects and possible bed wetting

They found out one med helped psychosis but caused bad gastro side effects, decades ago. Then 8-9 years ago Karuna found a second med that mitigated most of the gastro side effects and patented the combination. Then testing on the two took years.


I had high hopes for Karxt. Now, there is a big chance it won’t be approved and if gets approved there is a big chance I won’t be able to tolerate side effects. There is also a chance it wont be anything revolutionary.

A company paid $14 billion for rights to it. They must have been pretty sure it will get approved.


I agree. companies don’t dish out money for patents willy nilly - there’ a (demand) market for KarXT

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According to ICER, the price will say a lot about KarXT. If the price is 1600-1700 dollars then that means the medication will be very good. If it is 1400-1500 there will not be so much ‘‘revolution’’.

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That’s roughly the monthly bill for my Vraylar.

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So, let me get this right. If its garbage they will charge you 1500. If it actually works well, its another 15% ?

All this for a product that probably costs 50 bucks to produce a months supply.

I know they say you are paying for research and development too, but I gotta say, these pharmacutical companies got a hell of racket going on :smile:.


Bristol Meyers Squib paid the $14 billion. They would have to charge a lot to even get their money back.
Karuna Pharm pattented the combo and ran the trials. They made out like bandits.
The price could be $2000 a month or more for all we know.

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Maybe I’m not understanding everything here. But based on a short internet search it appears Bristol Meyers bought up Karuna…like as in a merger. So this means they dont just own Karxt, they also own the company and its assets.

I’m not seeing how you are thinking they are just going to break even. It supposedly can be used for schizophrenia, bipolar and alzheimers disease.

I mean, say that they just get a million people worldwide using it, which to me, sounds like a conservative estimate considering the variety of conditions and number of people with those conditions. The simple math at 2000 dollars a month is 2 billion dollars a month in sales. Thats 24 billion in one year.

Maybe I’m missing something , though.

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I’m great on my perphenazine so I’m not gonna try it unless stuff hits the fan. Another plus is perphenazine is $60 a month with no insurance. I got insurance though so it’s free.

I’m def gonna try this. My pdoc mentioned ECT.

Results from google AI :

AI Overview

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Bristol Myers Squibb (BMS) acquired Karuna Therapeutics, the developer of KarXT, for $14 billion in December 2023. BMS expects KarXT to help grow sales and diversify its neuroscience portfolio into the next decade. KarXT is a new type of medication for treating schizophrenia in adults that has shown promise in clinical trials and could be approved by the FDA by September 26, 2024. Some analysts predict that KarXT could reach peak sales of $10 billion and that BMS could see yearly sales of over $6 billion if it’s approved for other uses, such as bipolar I disorder and Alzheimer’s. However, the acquisition is expected to dilute BMS’s non-GAAP diluted earnings per share by about $0.30 in 2024.

So, I guess they expect around 16 billion a year in sales. I was off a bit, I guess. But who knows the monthly price.

BMS bought Karuna whose only real asset is KarXT, 2 generic older meds that were patented as a combo.No company before has spent a $billion to acquire an sz med. Some in trials of KarXT dropped out.
Any bipolar use would depend on future clinical trial results. Any Alzheimer’s use would be for agitation only with no guarantee that happens. There are already cheaper meds for Alzheimer’s agitation.
Patients stable on their meds and their doctors might be reluctant to switch.
Many foreign health agencies delay new med use for years until prices go down.
BMS thought they would make money eventually and they likely will. But no other company made such an offer.

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they are hoping to use it for alzheimers related psychosis as well.

Delivering Meaningful Benefits to Patients with KarXT

KarXT targets both the M1 and M4 muscarinic receptors, resulting in a differentiated safety and efficacy profile. KarXT has demonstrated improvements in cognition and is not associated with common side effects of currently approved treatments, including weight gain, extrapyramidal symptoms, increased prolactin levels, akathisia and/or sedation.

Given this differentiated profile, KarXT has meaningful and expanding revenue potential in schizophrenia and with upside in additional indications and geographies:

  • Schizophrenia: KarXT is expected to launch in late 2024 in the U.S. as a treatment for schizophrenia in adults. There are approximately 1.6 million1 people treated for schizophrenia in the U.S., a significant portion of whom do not respond to currently available therapies and experience unacceptable side effects.
  • Adjunctive schizophrenia: A registrational clinical trial is currently underway evaluating KarXT as adjunctive treatment with current standard of care agents for the treatment of schizophrenia, with data expected in 2025.
  • Alzheimer’s disease psychosis: Registrational clinical trials are currently underway evaluating KarXT for the treatment of Alzheimer’s disease psychosis, with data expected in 2026. There are more than 6 million2 people living with Alzheimer’s disease in the U.S. There are currently no approved treatments for Alzheimer’s disease psychosis.
  • Additional indications: Bristol Myers Squibb believes KarXT also has potential in additional indications, including Bipolar I disorder, which impacts approximately 1.4 million1 people in the U.S., and Alzheimer’s disease agitation.

I won’t even bother with it unless I see it changing peoples’s lives all over.

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If it can truly help with negatives…I will probably eventually try it. I will probably try to hold out a few years so that some/any of the unknown side effects can be seen. But if it truly helps with negatives, and if we see lots of testimonials on it doing this, its going to be difficult not to give it a shot.

Oh, same. I am not above using complete strangers as guinea pigs, however.


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Well someone somewhere got to try the medicine first before there can be widespread distribution