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          Adam's take main illustration
          Molly Ferguson/STAT

          Cytokinetics was founded 26 years ago but has not yet developed a drug successfully to approval. That makes Tuesday’s Food and Drug Administration decision on its treatment for heart failure a big deal — except nearly everyone, even investors who own Cytokinetics — hopes the agency rules against it.

          Hoping the FDA rejects the Cytokinetics drug, called omecamtiv mecarbil, is a relatively uncommon, up-is-down, down-is-up situation, but it makes sense in this case because the business and science of the drug are not aligned.

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          Consider: Cytokinetics shares rose in December when an outside group of experts convened by the FDA to examine omecamtiv’s benefits and risks recommended against the medicine’s approval. On Tuesday, the FDA is most likely to heed that advice and turn down the company’s marketing application.

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