Every year, the list of top pharmaceutical products and companies by sales sees some churn. But the year 2021 was a lot different — it saw the pharma industry landscape change dramatically. It was a
year when the industry was busy developing vaccines and therapies so that the
world could recover from the Covid-19 pandemic. And this resulted in many
drugmakers raking in billions of dollars in sales.
As a result,
the top company of 2020 in terms
of pharmaceutical sales — Roche — slipped to the number five spot, while Pfizer, which was at number eight in 2020 after
spinning off its generic business, moved up to the number one slot.
The year
proved to be a good one for pharmaceutical companies.
Interestingly, last year none of the top 20 pharmaceutical companies saw a decline in
their revenue.
View Our Interactive Dashboard on Top Drugs by Sales in 2021 (Free Excel Available)
Pfizer’s Comirnaty steals the show
The
company that reaped the maximum gains from its Covid vaccine was Pfizer.
Comirnaty (tozinameran) was the top selling pharmaceutical
product of 2021, posting global revenues of US$ 36.8 billion. This
messenger-RNA Covid-19 vaccine, developed along with its German partner BioNTech, catapulted Pfizer to the slot of the top company by sales in 2021. Pfizer’s global topline grew from US$ 41.7 billion in 2020 to US$ 81.3 billion in 2021.
In
2020, Pfizer was at
number eight, behind Roche, Novartis, GSK, AbbVie, J&J, Merck and BMS. In 2021, it took a lead of billions of dollars on all these companies. The second largest drug company by sales — AbbVie — was way down at US$ 56.1 billion in global revenues. In fact, Comirnaty has
become the fastest-selling drug in the history of the pharmaceutical
industry.
Back in
December 2020, when both Comirnaty and Moderna’s Spikevax had bagged the US Food and Drug Administration’s emergency use authorization (EUA), there was a lot of uncertainty around how the promised doses would be delivered across the world. But both Comirnaty and Spikevax have proven to be a resounding success. Spikevax emerged as the third largest selling pharmaceutical product of 2021, bringing in US$ 17.7 billion for Moderna.
Analysts
expect both Pfizer-BioNTech and Moderna to sell even more vaccines in
2022. The reasons are manifold. First, SARS-CoV-2 is able to mutate often, and
is unlikely to be eradicated in the near future, creating a need for booster
shots. Second, the younger age groups are still to get vaccinated.
Along with
Comirnaty, Pfizer is battling Covid-19 with its antiviral pill, Paxlovid. Though the sales of Paxlovid have nosedived of late, Pfizer expects
Comirnaty and Paxlovid to help the New York-headquartered drug behemoth achieve US$ 100 billion
in 2022 revenues.
View Our Interactive Dashboard on Top Drugs by Sales in 2021 (Free Excel Available)
AbbVie
moves up, sans Covid product; Roche slips to number five
With no
Covid-19 related products, AbbVie did fairly well in 2021 — it moved up from the number four spot in 2020 to number two position, thanks to its Allergan acquisition, cash cow Humira (adalimumab), the continued success of its
cancer drug Imbruvica (ibrutinib) and an increase in sale of its psoriasis treatment Skyrizi (risankizumab) by a whopping 85 percent in 2021. Humira brought in sales of US$ 21.2 billion for AbbVie in 2021. However, things may change soon, with biosimilars of Humira slated to enter the market in 2023. The years 2022 and 2023 are likely to be transition years for AbbVie, as it works to build the market for its Humira successors — Rinvoq and Skyrizi.
Roche
emerged as a big loser in 2021, as several copycats of its blockbuster drugs
hit the market. Copycats to Roche’s three blockbuster cancer drugs—Avastin, Herceptin and Rituxan—eroded US$ 4.9 billion (CHF 4.73 billion) from the company’s sales in 2021. A large chunk
of growth for Roche came from its multiple sclerosis med Ocrevus, hemophilia drug Hemlibra, inflammatory disease therapy Actemra and PD-L1 inhibitor Tecentriq. The pandemic resulted in
lower-than-expected sales of Ocrevus (ocrelizumab) due to fears around its
immunosuppressive effects.
Like Roche, Novartis also slipped last year. It fell from
number two in 2020 to the number four slot in 2021. Essentially, Novartis is
struggling with a relatively lackluster pipeline. It had sold its 33 percent stake in Roche last
year for US$ 20.7 billion. It plans to use that sum for acquisitions in order
to beef up its pipeline. The Swiss drugmaker has also drawn up a restructuring
plan that includes layoffs of thousands of employees.
Before the
pandemic, Merck’s Keytruda was touted as the drug that would overtake
Humira at the top in 2024. The checkpoint inhibitor has continued to grow
impressively, adding new indications and treatment lines. Keytruda is now used
in close to 40 indications. With US$ 17.2 billion in sales, Keytruda emerged as
the fourth largest selling drug of 2022.
Overall
though, Merck slipped from number six to the number eight slot. This was due to
the fact that Merck had spun out its women’s
health, biosimilars and established brands businesses into Organon. However, its Covid-19 antiviral pill — Molnupiravir — was able to compensate for the lost revenue. Though the FDA is yet to grant the drug a full approval (it bagged an EUA in December 2021), advance sales agreements helped it rack up US$ 952 million in sales in the fourth quarter.
View Our Interactive Dashboard on Top Drugs by Sales in 2021 (Free Excel Available)
BMS moves
up with Eliquis, Revlimid; J&J lands at number three
Bristol Myers Squibb (BMS) moved up from number seven in 2020 to number six, thanks to two of its drugs that made it to top 10 — anticoagulant Eliquis at number five and oncology drug Revlimid at number six. However, Revlimid will soon face competition — four generic companies now have the approval to sell their versions of Revlimid (lenalidomide) after March 2022. Revlimid
sales are expected to drop from US$ 12.9 billion to just US$ 2.06 billion in
2026.
BMS posted
US$ 46.4 billion in global revenues, a nine percent increase from US$ 42.5
billion reported in 2020. In immuno-oncology, Opdivo
brought in US$ 7.52
billion in sales, while Yervoy drew in sales of US$ 2 billion
(an increase of 20 percent).
J&J’s pharma division brought in US$ 52.1 billion in revenues
last year, an increase of 14 percent over its revenues of US$ 45.6 billion
posted in 2020. Drugs like Darzalex (for multiple myeloma), Stelara and its Covid-19 vaccine brought in growth during 2021,
helping J&J move up from number five to the number three slot. J&J’s Covid-19 vaccine brought in US$ 2.4 billion in
sales.
View Our Interactive Dashboard on Top Drugs by Sales in 2021 (Free Excel Available)
GSK bags
approval for shingles vaccine; Takeda suffers setbacks
GlaxoSmithKline (GSK) slipped four places — from number three in 2020 to number seven in 2021. Though GSK did not have a drug in the top 10, sales of GSK and Vir Biotechnology’s Covid-19 antibody treatment
sotrovimab helped produce a seven percent increase in its 2021 revenue. The British drugmaker also bagged a critical FDA approval — its vaccine to prevent shingles (herpes zoster), Shingrix, bagged the agency’s nod in July. GSK hopes to double the sales of Shingrix by 2026.
GSK is also undergoing a major transformation, and plans to demerge its consumer health unit this year. The unit generated revenues of £9.6 billion (US$ 13 billion) last year, and GSK sees the demerger as a necessary step to fuel growth through the development of new vaccines and specialty medicines.
Sanofi managed to retain its ninth slot, even as
its global turnover increased from US$ 39.3 billion (Euro 36.04 billion) to US$
41.6 billion (Euro 37.76 billion). It snapped up Kymab, Tidal Therapeutics, Translate Bio, Kadmon Holdings, Origimm Biotechnology and Amunix in deals that bolstered its presence in immunology, immuno-oncology and vaccines. Dealmaking is on the French drugmaker’s menu for 2022 and beyond, Sanofi’s CFO said at this year’s virtual JP Morgan Healthcare Conference.
AstraZeneca’s global revenues grew from US$ 26.6 billion in 2020 to US$ 37.4 billion in 2021. However, its rank fell from nine in 2020 to 10 in 2021.
AstraZeneca
wrapped up the US$ 39 billion acquisition of Alexion in July 2021. Alexion’s rare disease franchise—led by C5 inhibitors Soliris and Ultomiris—added an extra US$ 3.1 billion to Astra’s top line last year.
Takeda suffered several clinical and regulatory setbacks in 2021, which it labeled as an “inflection year.” For Gilead, sales of its Covid-19 antiviral Veklury brought in US$ 5.6 billion last year,
helping its revenues grow by 11 percent.
View Our Interactive Dashboard on Top Drugs by Sales in 2021 (Free Excel Available)
Our view
If anything,
the pandemic has taught us that change is the only constant. It has also taught
us that products can become blockbusters in a matter of a few months.
The industry
landscape continues to change. On the one hand, we are seeing people scrambling
to get Covid vaccines and booster shots, on the other hand, the FDA has limited the use of monoclonal antibodies, such as Eli Lilly’s bamlanivimab and etesevimab and
Regeneron’s REGEN-COV (casirivimab and
imdevimab), in treating Covid caused by the Omicron variant. The FDA has also pulled the authorization
granted to GSK and Vir Biotechnology’s antibody therapy this month,
citing data that suggested it was unlikely to be effective against the dominant
Omicron sub-variant.
And last
week, there was news that demand for Pfizer’s
antiviral pill Paxlovid has remained unexpectedly low. The supply
of Paxlovid, which reduced hospitalizations or deaths in high-risk patients by
around 90 percent in a clinical trial, has far outstripped demand in many
countries like the US, the UK and South Korea.
Though Pfizer is hopeful of crossing US$ 100 billion in revenue this
year, much depends on how the pandemic pans out and what new research has to
say about the novel coronavirus. A lot will change once the pandemic becomes endemic.
The first four months of 2022 tell us that vaccines like Comirnaty and Spikevax
will continue to perform well.
But two years down the line, our charts could look very different.
Impressions: 8031
Last
year, the pandemic impacted everyone’s life in one way or the other. It turned
the limelight on to the pharmaceutical industry, which stepped up efforts to
deliver treatments and vaccines for Covid-19. It was a year of challenges for
the drug
industry as it struggled to supply existing drugs and treat emergencies
amid disruptions in the way business was conducted the world over.
Unlike previous years when the top five drug companies largely remained unchanged, 2020 saw several movers and shakers. The acquisition of Allergan by AbbVie helped it enter the ‘top five’ list, while companies like Pfizer and Merck got edged out. Despite a 2 percent increase in revenues, Pfizer dropping out
of the top five was not a complete surprise as it spun-off its
Upjohn unit. The unit merged with Mylan to create Viatris, an entity
with over US $10 billion in revenues.
View Our Interactive Dashboard on Top drugs by sales in 2020 (Free Excel Available)
Roche emerges as top drug company by global sales
The
top five list of global pharmaceutical companies by sales in
2020 was quite a mix of surprises. While Swiss major Roche topped the
ranking of global drug companies by pharmaceutical sales (with global revenues
of US$ 49.6 billion or CHF 44.532 billion), it also witnessed a sales decline
of 8 percent, which was partially an outcome of the Swiss franc gaining against
most currencies during the pandemic. Overall, competition from biosimilars and the Covid-19 pandemic had a negative impact on Roche’s
pharmaceutical sales in 2020. However, it witnessed strong sales growth
of newly launched medicines like Tecentriq, Hemlibra, Ocrevus, Perjeta and Kadcyla, which
helped in offsetting the CHF 5 billion (US$ 5.53 billion) impact of competition
from biosimilars.
At
the
second position was Swiss drugmaker Novartis, whose global sales (at US$ 48.7 billion) were marginally lower than Roche’s. Unlike the numero uno, Novartis’ pharmaceutical sales grew 4 percent, driven by cardiology drug Entresto that witnessed a 44 percent increase in revenues. While its
oncology unit and Sandoz’s biosimilars business also posted an increase in sales, Covid-19 negatively impacted demand, particularly for the company’s ophthalmology and dermatology operations and the retail operations of Sandoz. The year also saw Novartis’ gene therapy
Zolgensma, the world’s costliest drug, reach nearly US$ 1
billion in sales.
As
the British pound became a lot stronger against the US dollar, GlaxoSmithKline Plc (GSK) witnessed a 3 percent increase in sales in constant currency terms and saw its group sales (£ 34.1 billion or US$ 47.27 billion) take the number three spot in US dollar terms. Strong sales performances
from key growth drivers in HIV, respiratory, oncology and consumer healthcare
offset disruptions from Covid-19. GSK’s consumer healthcare division reported over £10 billion (US$ 13.91 billion) in sales and the firm is on track to create new standalone biopharma and consumer healthcare companies in 2022.
View Our Interactive Dashboard on Top drugs by sales in 2020 (Free Excel Available)
AbbVie’s international Humira sales
drop 13.6% due to biosimilars
AbbVie reported worldwide revenues of US$ 45.8
billion, an increase of 38 percent versus the previous year. This included US$ 10.3
billion in revenues from the Allergan acquisition,
growth in the immunology portfolio, and the continued strength of Humira in the US as
well as revenue growth from Imbruvica and Venclexta. Humira, the
best-selling drug since 2012, continued to dominate with US$ 19.83 billion in
sales, an increase of 3.5 percent as compared to 2019. While the
international sales of Humira dropped 13.6 percent due to competition from biosimilars, in the US sales increased as Humira is protected from biosimilar competition until 2023.
J&J’s
pharmaceutical division delivered a strong performance as its pharmaceutical
sales grew 8 percent to US$ 45.6 billion and contributed more than the combined sales of its other two units — consumer health and medical devices. This sales growth was largely attributed to primary operational drivers including Imbruvica and Stelara, which were
among the top 10 drugs by sales in 2020. J&J and AbbVie have an equal share
in the profits (and losses) from the sales of Imbruvica, which witnessed a
double digit increase in sales to US$ 9.4 billion. Similarly, J&J’s Stelara
reached US$ 8.0 billion in sales. J&J’s overall revenues grew by just 0.6 percent
to US$ 82.6 billion (including sales from its consumer health and medical
devices divisions). It will be interesting to see what J&J’s 2021
revenues look like as it benefits from the sales of its single-dose Covid-19
vaccine.
View Our Interactive Dashboard on Top drugs by sales in 2020 (Free Excel Available)
Merck’s Keytruda on its way to becoming world’s best-seller
With AbbVie’s Humira beginning to face generic competition, Merck’s oncology
drug Keytruda continued to go from strength to strength posting a sales growth of 30
percent. Keytruda delivered more than US$ 14.4 billion in sales, almost a third
of the firm’s US$ 43 billion revenue. It’s only a matter of time before Keytruda becomes the world’s best-selling drug.
Bristol Myers Squibb (BMS)
reported worldwide revenues of US$ 42.5
billion in 2020. BMS’ products Revlimid and Eliquis reported
significant growth last year, and followed Humira and Keytruda in terms of sales. Eliquis, which is also promoted by Pfizer in some geographies,
had total sales of US$ 14.1 billion while Revlimid posted over US$ 12 billion
in sales. Revlimid, which BMS picked up through its acquisition
of Celgene, will face
limited generic competition sometime after March 2022. Furthermore, while BMS’ oncology
treatment Opdivo’s sales (US$
7.2 billion) declined by 3 percent compared to 2019, it remained one of the top selling drugs in 2020 (US$
7.9 billion) with a small portion of sales coming from Ono Pharma in Japan.
Sanofi reported
approximately US$ 43.6 billion (€36 billion) in net sales
for 2020, which rose by 3.3 percent at constant exchange rates even as some of
its flagship products’ sales declined due to generic and
biosimilar competition. Solid performances from Dupixent, vaccines and its
specialty care global business unit across all geographies, more than offset
lower sales.
In
the case of Gilead, while
products like Biktarvy in its HIV
portfolio witnessed a growth of over 50 percent to more than US$ 6 billion,
it was Gilead’s treatment for Covid-19 — remdesivir — promoted under the brand Veklury which went from no sales in 2019 to US$ 2.81 billion in sales in 2020.
View Our Interactive Dashboard on Top drugs by sales in 2020 (Free Excel Available)
Our view
The
human health business of many companies was negatively impacted by the Covid-19
pandemic. However, operating expenses saw a reduction due to lower promotional
and selling costs, as well as lower R&D expenses.
This
year, as Covid vaccines from Pfizer, Moderna, J&J and AstraZeneca are rolled out in more
countries across the world, they are expected to ring in significant
revenue contributions for these companies. For instance, Pfizer recently announced
that it expects US$ 26 billion in revenues from the sale of its vaccine
in 2021. Similarly, Moderna said it expects US$ 19.2 billion in sales from its Covid-19 vaccine this
year.
Given this scenario, the order of the top drug companies and the sales contribution of various drugs will change significantly in 2021. It seems likely that Pfizer’s vaccine will become the best-selling product by sales in 2021 and the American drugmaker will be back among the top five in the global drug companies by sales list.
View Our Interactive Dashboard on Top drugs by sales in 2020 (Free Excel Available)
Impressions: 13264
The year
2020 was an eventful year for the pharmaceutical industry, with several
companies across the world working at a feverish pace to find a treatment or a
vaccine for the raging Covid-19, which has so far taken over 1.79 million lives
worldwide.
With
countries imposing lockdowns and regulators putting on-site inspections on
hold, we were expecting far lower new drug approvals in mid-2020. But our mid-2020 recap published in July, which
looked at new drug approvals by the US Food and Drug Administration (FDA) and European Medical Agency (EMA),
found that the FDA had approved 33 new drugs by the end of June. This put the
approvals within the ballpark of the past two years.
This week, we bring you a roundup of 2020, a tumultuous year when 58 drugs (53 approvals by the Center for Drug Evaluation and Research and 5 by the Center for Biologics Evaluation and Research) bagged FDA’s new drug approvals. While this number is lower than the number of drugs approved in 2018 (62), it is higher than the number for 2019 (54). Out of this, while 23 approvals were in the field of oncology, 9 were for infectious diseases and infections, 8 for genetic diseases, 7 for neurology, 3 for immunology and 2 for gastroenterology.
View New Drug Approvals in 2020 with Estimated Sales (Free Excel Available)
A year marked by EUA
With the pandemic raging across the world, emergency use authorizations (EUAs) dominated news headlines in 2020 — the FDA issued 10 EUAs, with the most
prominent being those issued to Pfizer-BioNTech and Moderna for their Covid-19 vaccines.
EMA was busy as well since they issued 75 positive opinions
with Novartis leading
the pack with 8, followed by Pfizer and Sanofi which received 4 each.
The EUAs came with their own set of controversies. In March,
the FDA had issued an EUA “for oral formulations of chloroquine phosphate and hydroxychloroquine sulfate
for the treatment of” Covid-19. However, by June, FDA had revoked the EUA,
as the agency determined that chloroquine and
hydroxychloroquine were not likely to be effective in treating Covid-19 for the
authorized uses in the EUA.
Amongst treatments for Covid-19, in May the FDA
authorized the emergency use of Gilead’s antiviral
drug remdesivir. In our mid-2020 recap, Gilead’s remdesivir was on top of
our list of top-selling drugs after it received an EUA from the FDA.
In October, remdesivir became the first drug to
be approved by the FDA for treatment of Covid-19 patients requiring
hospitalization. While analysts predicted US$ 3.5 billion in revenue in early
October, the future of this drug as a treatment for Covid-19 in hospitalized
patients remains uncertain, especially in wake of results from the World Health
Organization (WHO)-led Solidarity Trial that said Gilead’s remdesivir
had little or no effect on the 28-day mortality or length of hospital
stays for Covid-19 patients. The FDA approved remdesivir for
hospitalized patients a week after the WHO results.
View New Drug Approvals in 2020 with Estimated Sales (Free Excel Available)
Gilead US$ 21 billion Immunomedics acquisition
Immunomedics' antibody-drug conjugate (ADC) — Trodelvy (sacituzumab govitecan-hziy) — was approved by the FDA in April this year for the treatment of adult patients with metastatic triple-negative breast cancer who have received at least two prior therapies for the disease. Such tumor types account for 15 to 20 percent of breast cancers. Trodelvy follows remdesivir in our list of FDA approved drugs in 2020 with the highest sales potential. The current forecast for Trodelvy sales is US$ 2.151 billion by 2026.
In
September, Gilead made a big move and acquired biotech company
Immunomedics Inc for US$ 21 billion. The
transaction, which was completed in October, will strengthen Gilead’s cancer portfolio and add another potential blockbuster to it.
Immunomedics
plans to submit a supplemental Biologics License Application (BLA) to support
full approval of Trodelvy in the US over the next quarter. According to a statement, Immunomedics
is also on track to file for regulatory approval of the drug in Europe in the
first half of 2021. Moreover, ongoing studies are also evaluating the potential
of Trodelvy as a treatment for non-small cell lung cancer and other types of
solid tumors.
View New Drug Approvals in 2020 with Estimated Sales (Free Excel Available)
Roche-PTC Therapeutics’ risdiplam bags approval
Following
Troveldy in sales potential for drugs approved by the FDA is Roche and PTC Therapeutics’ drug Evrysdi (risdiplam), the first oral medicine approved for the
rare genetic disease, spinal muscular atrophy, which until four years ago had
no available treatments.
The approval of Evrysdi presents patients and their families with a unique choice between a one-time gene therapy, an RNA-based drug infused three times a year at the doctor’s office and a daily medicine taken at home.
Roche priced the drug by patient weight, with a maximum cost of US$ 340,000 per year — substantially lesser than the competing (and approved) therapies from Biogen and Novartis.
View New Drug Approvals in 2020 with Estimated Sales (Free Excel Available)
Vertex’s Kaftrio bags EMA approval
Earlier
this year, PharmaCompass had published its compilation of sales
forecasts for the new drugs approved by the FDA in 2019. The list was led by Vertex’s cystic
fibrosis treatment — Trikafta — which was expected to have sales of US$ 3.935 billion by 2024.
Trikafta
is a combination of ivacaftor, tezacaftor and elexacaftor and its
stellar clinical data made the FDA approve the drug within three months of
Vertex’s application
filing and five months before FDA’s action date.
In
June 2020, EMA’s CHMP adopted a positive opinion, recommending the granting of a marketing authorization for
Vertex’s
combination, which will be marketed as Kaftrio.
View New Drug Approvals in 2020 with Estimated Sales (Free Excel Available)
A year
of multiple setbacks
Not everything went smoothly in 2020. In fact, the year saw several setbacks — almost 44 drugs were not granted approval by the FDA. Bristol Myers Squibb was one such company that
received setbacks. As part of Bristol’s US$ 74 billion acquisition of Celgene, the New
York-headquartered drug company offered Celgene shareholders Contingent Value Rights or
CVRs. But to realize the US$ 9-a piece payment, approvals for three
ex-Celgene drugs must meet their pre-specified deadlines.
While in March, the FDA approved Bristol’s ozanimod, a sphingosine-1-phosphate receptor agonist for the treatment of relapsing multiple sclerosis, well ahead of the December 31, 2020 deadline, in May, Bristol Myers Squibb and bluebird bio, Inc announced
that they have received a Refusal to File letter from FDA regarding the Biologics License Application (BLA) for their CAR-T therapy — idecabtagene vicleucel
(ide-cel) — for patients with heavily pre-treated relapsed and refractory multiple myeloma, which was submitted in March 2020. Upon preliminary review, the FDA
determined that the Chemistry, Manufacturing and Control (CMC) module of the
BLA requires further details to complete the review.
This was
followed by Bristol Myers announcing that the FDA has extended the action date
by three months for the BLA for lisocabtagene maraleucel (liso-cel), a
CD19-directed CAR-T therapy for the treatment of adults with relapsed or
refractory (R/R) large B-cell lymphoma after at least two prior therapies. The
FDA had then set the new Prescription Drug User Fee Act (PDUFA) action date as
November 16, 2020. However, on that day, FDA informed the company that its
review of the BLA for liso-cel will not be completed by November 16.
The FDA
approval of liso-cel by December 31, 2020 is one of the required remaining
milestones of the CVRs issued upon the close of the Celgene acquisition in the
fourth quarter of 2019. The other is FDA approval of ide-cel by March 31, 2021.
FDA declines approval to Novartis’ inclisiran: Recently, there was news that
the FDA declined to approve Swiss drugmaker Novartis AG’s lipid-lowering therapy, inclisiran (branded as Leqvio). The drug came to Novartis' fold through the
US$ 9.7 billion acquisition of The Medicines Company last year. The drug has been cleared by the European Commission.
In a statement, Novartis said the
FDA has not raised any concerns
related to the efficacy or safety of inclisiran. The complete
response letter (CRL) is due to unresolved facility inspection-related
conditions. No onsite inspection was conducted by the FDA, the company said.
View New Drug Approvals in 2020 with Estimated Sales (Free Excel Available)
Our
view
Like the
drug companies, regulators across the world also worked at a frenetic pace in
order to accelerate EUAs and drug approvals, especially for treatments and
vaccines for Covid-19.
Apart from
Covid-19, the year saw wider adoption and
approvals for cell and gene therapies along with approvals of several innovative medicines like relugolix (the first
oral gonadotropin-releasing hormone receptor antagonist for the treatment of
adult patients with advanced prostate cancer), berotralstat
the first oral once daily plasma kallikrein inhibitor to prevent attacks of
hereditary angioedema in adults and pediatric patients 12 years and older,
lumasiran (an HAO1-directed small interfering
ribonucleic acid indicated for the treatment of primary hyperoxaluria type 1 to lower urinary oxalate levels in pediatric and adult
patients) and osilodrostat for the treatment of adults with Cushing’s disease).
Moreover, there were several interesting ‘non-Covid’ medical breakthroughs that took place during 2020. One such breakthrough is a single pill that combines four medications meant to
lower blood pressure and cholesterol and aspirin that was found to cut the risk
of heart disease.
While the agility shown by pharma companies and regulators was
undoubtedly quite impressive, with many countries granting EUA to vaccines for
Covid-19, the ongoing pandemic did put mankind in a bind for several months.
And if the words of the WHO director general Tedros
Adhanom Ghebreyesus are to be believed, the
coronavirus crisis will not be the last pandemic and attempts to improve human health are “doomed” without tackling climate change and animal welfare.
If that really proves to be the case, the pharma industry has a lot to learn from this pandemic, and science has a lot to demonstrate if mankind is to emerge unscathed from such adversities.
View New Drug Approvals in 2020 with Estimated Sales (Free Excel Available)
Impressions: 6921
In case you thought Covid-19 had slowed down US Food and Drug Administration’s New Drug Approvals, you’re in for a pleasant surprise — the FDA appears to be more active than ever before. By the end of June, the FDA had already approved 33 new drugs which put the approval activities within the ballpark of the past two years — 62 novel drugs were approved in 2018, while 54 were approved in 2019.
FDA’s Center for Drug Evaluation and Research (CDER) approved 25 new molecular entities and new therapeutic biological products, of which almost half — 12 out of 25 — were oncology drugs, while the rest of
the novel therapies were approved by the Center for Biologics Evaluation and Research.
The European Medical Agency (EMA) was also busy as the regulator issued a positive opinion for 41 drugs, of which 27 were classified as novel treatments.
View New Drug Approvals by June 2020 with Estimated Sales (Free Excel Available)
Conditional Approval for Gilead’s Remdesivir
Gilead’s Remdesivir has
certainly been one of the most talked about drugs
this year. While it is still under clinical evaluation, the FDA, EMA and the
Japanese Ministry of Health, Labour and Welfare (MHLW) found ways of providing
market access to this drug as a treatment against Covid-19.
On May 1, 2020, based on the totality of
scientific evidence available to the FDA, the
agency issued an Emergency Use Authorization (EUA), as it believed
that remdesivir may be effective
in treating Covid-19 and that the known and
potential benefits of remdesivir, when used to
treat Covid-19, outweigh the known and potential risks of such products.
On June 25, 2020, EMA’s Committee for Medicinal Products for Human Use (CHMP) adopted a positive opinion, recommending the granting of conditional marketing authorization for Veklury (remdesivir).
The demand for remdesivir is such that the US bought more than 500,000 doses, which is all of Gilead’s production for July and 90 percent of production for August and September, leaving almost
no stock of remdesivir for the UK and Europe.
In 127 poor or middle-income countries, Gilead
is allowing generic drugmakers to supply remdesivir. It has signed non-exclusive voluntary licensing
agreements with generic pharmaceutical manufacturers based in Egypt, India and
Pakistan to further expand the supply of the antiviral drug.
View New Drug Approvals by June 2020 with Estimated Sales (Free Excel Available)
Vertex’s Kaftrio bags EMA approval
Earlier this year, PharmaCompass published its compilation of the sales forecasts for the new drugs approved by the FDA in 2019. The list was led by Vertex’s cystic fibrosis treatment — Trikafta — which is expected to have sales of US$ 3.935 billion by 2024.
Trikafta is a combination of ivacaftor, tezacaftor and elexacaftor and its stellar clinical data made the FDA approve the drug within three months of Vertex’s application filing and five months before FDA’s action date.
In June 2020, EMA’s CHMP adopted a positive opinion, recommending the granting of a marketing authorization for Vertex’s combination which will be marketed as Kaftrio.
EMA also adopted positive opinions on other
drugs which were previously approved by the FDA in
2019, such as Novartis’ Zolgensma and Piqray, Pfizer’s Staquis and Daurismo among many
others.
Immunomedic’s antibody-drug conjugate (ADC) — Trodelvy (sacituzumab govitecan-hziy) — was approved by the FDA for the treatment of adult patients with metastatic triple-negative breast cancer who have received at least two prior therapies for metastatic disease. Trodelvy follows remdesivir in our list of FDA approved drugs in 2020 with the highest sales potential. The current forecast for Trodelvy sales is US$ 2.151 billion by 2026.
FDA’s approval of Lundbeck’s Vyepti (eptinezumab) and Biohaven’s Nurtec ODT (rimegepant) for migraine
headaches brought additional CGRP-targeted products to the market. It will be
interesting to see how Nurtec ODT is accepted given it is a small molecule
drug, which makes administration easier. It was
recently promoted on social media by Khloe Kardashian.
View New Drug Approvals by June 2020 with Estimated Sales (Free Excel Available)
Covid-19 impacts drug launches
The pandemic has, however, started taking a
toll on drug launches. One of the most anticipated drug approvals of the year, Bristol-Myers Squibb’s multiple sclerosis (MS) treatment — Zeposia (ozanimod) — was approved in both the US and Europe. However, the launch of the drug would
be delayed due to the coronavirus outbreak.
The drug was added to BMS’s portfolio through its US$ 74 billion acquisition of Celgene last year. Its
approval was one of the three conditions set for a potentially higher payout
for Celgene investors.
Analysts have high hopes from ozanimod. Its
average peak sales for 2024 have been predicted to be at US$
1.62 billion by Cortellis, though the Covid-19 pandemic may weigh in there
as well.
View New Drug Approvals by June 2020 with Estimated Sales (Free Excel Available)
First non-statin cholesterol drug bags
FDA approval
This year also witnessed the first non-statin
treatment to be cleared for sale in the US in nearly 20 years. The drug, bempedoic acid, is made by Esperion Therapeutics Inc. This cholesterol-lowering drug is aimed at
helping millions of people who can’t tolerate or don’t get enough help from widely used statin pills like Lipitor and Crestor.
This new drug is to be used as an add-on treatment with statins. It lowers bad
cholesterol or low-density lipoprotein (LDL) by inhibiting its synthesis in the
liver. It targets patients with high cardiovascular risk.
Esperion also won approval of bempedoic acid
in combination with ezetimibe, another
cholesterol-lowering drug.
In January last year, Daiichi Sankyo Europe had entered into an exclusive licensing agreement with Esperion Therapeutics for Daiichi Sankyo Europe to market
bempedoic acid and bempedoic acid/ezetimibe combination tablet in the European
Economic Area and Switzerland.
View New Drug Approvals by June 2020 with Estimated Sales (Free Excel Available)
Approvals not granted to almost 20 drugs
There were setbacks too, and not everything
rolled smoothly. This year, almost 20 drug approvals were not granted. Among
the major setbacks were Bristol Myers Squibb and bluebird bio, Inc announcing
that they have received a Refusal to File letter from the FDA regarding the Biologics License
Application (BLA) for their CAR-T therapy, idecabtagene vicleucel (ide-cel), for patients with heavily pre-treated
relapsed and refractory multiple myeloma, which was
submitted in March 2020.
Upon preliminary
review, the FDA determined that the Chemistry, Manufacturing and Control (CMC)
module of the BLA requires further detail to complete the review. No additional
clinical or non-clinical data have been requested or are required.
Two years after Intarcia Therapeutics received
a CRL for its matchstick-sized, long-term drug
implant for type 2 diabetes, the FDA issued a second CRL to the company for its ITCA-650 implant. The
implant is designed to be a small, osmotic pump which can be slipped under the
skin and deliver a continuous, six-month dose of the
GLP-1 agonist exenatide.
The FDA also did not approve Intercept Pharmaceuticals’ obeticholic acid to treat NASH (or
nonalcoholic steatohepatitis, a liver condition in
which the buildup of fat
progressively scars the organ), as it wasn’t convinced that its benefits outweighed the potential risks.
After acquiring Allergan for US$ 63
billion, one of the first drugs which AbbVie was expecting
approval for was Abicipar pegol, their experimental DARPin therapy for patients with neovascular (wet) age-related macular degeneration (nAMD). However, FDA’s review indicated the rate of intraocular inflammation observed following administration of Abicipar pegol 2mg/0.05 mL
results in an unfavorable benefit-risk ratio in the treatment of wet AMD.
View New Drug Approvals by June 2020 with Estimated Sales (Free Excel Available)
Our view
While everyone’s attention is on the Covid-19 pandemic, the industry is certainly busy working towards getting new drugs to market. At the halfway mark, the FDA and EMA seem to be on track to set approval records this year, since the number of drugs approved by June are almost twice the number that were approved at the same time last year.
However, it remains to be seen how companies adapt their sales and marketing strategies in a world where mobility is likely to get restricted and interpersonal contact is set to reduce dramatically.
View New Drug Approvals by June 2020 with Estimated Sales (Free Excel Available)
Impressions: 69915
Now that the World
Health Organization (WHO) has declared the new coronavirus (2019-nCoV) as a public health emergency of
international concern, some of the biopharma industry’s
biggest names are taking important steps to combat the disease.
The death toll from the coronavirus outbreak
is rising each day. As many as 563 people have died in China, and the
virus has now spread to nearly 30 countries across the world, including Japan,
Thailand, Singapore, Hong Kong, South Korea, Australia, Malaysia, Germany,
India and the US.
In fact, infectious disease specialists and
scientists say the new coronavirus may be more contagious than what the current data suggests. The virus has spread from about 300 people on January 21
to over 28,000 people across the world. The numbers may be even higher as there
is limited testing capacity.
“The rapid acceleration of cases is of concern,” Dr. Mike Ryan, executive director of the WHO’s emergencies program said last week.
Health authorities all over the world are trying
to contain the outbreak. In the US, nearly 200 Americans were placed under
quarantine at a US air base in California after being evacuated from Wuhan,
China. Under the new restrictions, US citizens who
have traveled to China within the last 14 days will be directed to one of the
11 airports designated for screening. The FDA is halting travel of all its
employees to China and recalling its inspectors from the country.
Shortage of face masks, body suits
The fear of the fast spreading coronavirus has
led to an acute shortage of face masks in
Asia, the US and the UK. Manufacturers are increasing production to meet
surging demand.
In fact, China is the source
of most of the world’s masks and respirators. However, today it is using more masks than
it ever has. As a result, fewer masks and respirators will be available to the countries
that have been importing them from China.
In fact, former FDA commissioner Scott Gottlieb tweeted that China is witnessing a shortage of protective body suits. “Since much of supply chain for masks, gowns, gloves is through China; we should prepare for potential of stretched supply chains and increased demand here in US in event of outbreaks or epidemic spread in America,” Gottlieb tweeted quoting a Bernstein analysis
Meanwhile, India has banned the export of personal
protection equipment such as masks and clothing amid the global coronavirus
outbreak.
In Hong Kong, which has been struggling with a
shortage of face masks, toilet rolls became unavailable in some
supermarkets. Social media posts showed empty shelves and shoppers
lining up to buy rolls.
Success of flu, HIV drugs on coronavirus: Though there is no formal cure discovered to treat the virus, the
treatment protocol established in China and confirmed by physicians in Thailand
shows that a combination of Lopanvir and Ritonavir,
old generation drugs used to treat HIV, along with flu medication Oseltamivir,
has worked on patients.
Thai doctors have seen success of such a treatment. “This is not
the cure, but the patient’s condition has vastly improved. From testing positive for 10 days under our care, after applying this combination of medicine the test result became negative within 48 hours,” Dr. Kriangska Atipornwanich, a lung specialist at Rajavithi Hospital in Bangkok said.
Thailand has recorded 19 cases of coronavirus.
Of the Thai patients, eight have recovered and gone home while 11 are still
under treatment in hospitals.
Meanwhile, Indian drug companies say they are ready with supply of
anti-retrovirals (ARVs) that seem to work in treating the novel coronavirus.
Rise in screening tests: Roche has
developed a test that can tell whether or not someone has the 2019-nCoV
infection within a couple of hours. Roche’s coronavirus test hasn’t been
approved for marketing as yet.
Co-Diagnostics Inc has also said that the
initial verification of its screening test designed to identify the presence of
the coronavirus was successful.
Healthcare company Novacyt has also launched a
new molecular test for the Wuhan coronavirus.
The company said its Primerdesign coronavirus
test could detect the 2019 strain of the virus, adding it believed this would
differentiate it from other current tests which it said were less specific.
New coronavirus projects
There are multiple drugmakers and diagnostics
companies making noise about their coronavirus projects. Here are some
noteworthy projects:
Gilead’s remdesivir: Gilead’s experimental anti-viral treatment — remdesivir — has shown some positive results as
a patient in the US with worsening symptoms of a confirmed 2019-nCoV infection
has been treated with the drug. Remdesivir
appeared effective as a throat swab was tested negative for the virus just a
few days after receiving the infusion.
Incidentally, Gilead is developing remdesivir to combat the Ebola virus, not 2019-nCoV. Success from a single patient is great news, but the company needs more evidence to prove its case.
Gilead is also expediting laboratory testing of
remdesivir against samples of the new coronavirus. Last week, Anthony Fauci, director of the US
National Institute of Allergy and Infectious Diseases, said his agency was
working with Gilead to test remdesivir.
Gilead is also working with Chinese authorities
to begin a controlled, randomized study. However, such a study is bound to take
months.
Meanwhile, China has kick-started a clinical
trial to speedily test remdesivir for 2019-nCoV.
In fact, the virology institute in Wuhan has applied for a patent on this experimental
Gilead drug. Scientists have found remdesivir and chloroquine, an 80-year-old
malaria drug, to be highly effective in laboratory settings to thwart the novel
coronavirus. However, the two drugs’ efficacies
on humans required further clinical tests, the institute said.
Remdesivir
will also be tested by a medical team from Beijing-based
China-Japan Friendship Hospital for efficacy in treating the deadly new strain
of coronavirus.
Gilead said the drug was shown to be active in
animals with Severe Acute Respiratory Syndrome (SARS) and Middle East
Respiratory Syndrome (MERS), which are closely related to the current virus.
Moderna, J&J, GSK work on vaccines: Moderna, a
Massachusetts-headquartered biotechnology firm, is developing a vaccine to
prevent the coronavirus from spreading. Though there isn’t any accomplishment as yet, the Coalition for Epidemic Preparedness
Innovations (CEPI) has agreed to fund the manufacturing of a 2019-nCoV vaccine
that uses the company’s
proprietary messenger RNA (mRNA) platform.
Last week, Johnson & Johnson also said it would begin work on developing a vaccine for the
virus.
GlaxoSmithKline and CEPI also said they would work to accelerate the creation of
a vaccine. The goal is then to provide many vaccine doses rapidly, a statement
said.
The project will rely on GSK’s adjuvant
system, designed to enhance the body’s immune response and create a stronger and longer lasting
protection against infection. However, developing a preventive and confirming
that it is safe and useful in humans could take 12 to 18 months
Regulators, WHO prepare for new cures
The European Medicines Agency (EMA), US Food and
Drug Administration (FDA) and the WHO have taken various precautions and are preparing
themselves for new medicines, vaccines and in-vitro diagnostics (IVDs).
FDA has issued an Emergency Use Authorization (EUA) to authorize the emergency use of Centers for Disease Control and Prevention's (CDC) 2019-Novel Coronavirus (2019-nCoV) Real-Time Reverse Transcriptase (RT)-PCR Diagnostic Panel for the “presumptive qualitative detection of nucleic acid from the 2019-nCoV in upper and lower respiratory specimens (such as nasopharyngeal or oropharyngeal swabs, sputum, lower respiratory tract aspirates, bronchoalveolar lavage, and nasopharyngeal wash/aspirate or nasal aspirate) collected from individuals who meet CDC criteria for 2019-nCoV testing.”
To date, this test has been limited to use at CDC laboratories, but FDA said today’s authorization allows the use of the test at any CDC-qualified lab nationwide.
Similarly, EMA said it is ready to support drug developers with all available regulatory tools (i.e., scientific advice, the PRIME scheme, the accelerated assessment and conditional marketing authorization) to advance and expedite the development of ways to fight and prevent the spread of this virus.
WHO says ‘no effective treatment’ yet
The WHO has played down reports that talk of effective drugs that could treat the new coronavirus. Television reports in China have pointed to an effective drug for the virus. And Britain’s Sky News said researchers had made a “significant breakthrough” in developing a vaccine.
WHO spokesman Tarik Jasarevic said: “There are no known effective therapeutics against this 2019-nCoV (virus) and the WHO recommends enrollment into a randomized controlled trial to test efficacy and safety.”
“Even at the accelerated pace enabled by new technologies, the earliest that scientists hope to be able to start initial human trials of a new coronavirus vaccine is by June this year,” a Reuters news report said.
Our view
According to the WHO website, there have been multiple disease outbreaks over the last 20 years, including diseases like dengue, avian flu, zika virus, SARS, MERS and many others. Till date, most of these diseases don’t have a cure or a vaccine. These diseases are being treated by various antiviral drugs, and the treatments are largely symptomatic. “The process of developing and testing drugs or vaccines against a new pathogen normally takes many years and is often fraught with pitfalls and failures,” a Reuters report said.Most of the viruses are mutating at a fast pace, creating newer strains each year. Scientists are concerned that the 2019-nCoV has mutated to adapt to its new human hosts far more quickly than SARS. Data on the virus is changing by the day, and some infectious disease specialists say it will take weeks before they can see just how contagious it is. Scientists believe the virus is more contagious than what the current data suggests.Clearly then, this is a race between a fast-spreading and fast-mutating virus and the skills of the biopharmaceutical industry to contain its spread. This time though, the pharmaceutical industry is showing a lot of urgency in finding a vaccine as well as a cure.
Impressions: 2151