Droxidopa
Top drugs and pharmaceutical companies of 2019 by revenues
Acquisitions and spin-offs dominated headlines in 2019 and the tone was set very early with Bristol-Myers Squibb acquiring New Jersey-based cancer drug company Celgene in a US$ 74 billion deal announced on January 3, 2019. After factoring in debt, the deal value ballooned to about US$ 95 billion, which according to data compiled by Refinitiv, made it the largest healthcare deal on record. In the summer, AbbVie Inc, which sells the world’s best-selling drug Humira, announced its acquisition of Allergan Plc, known for Botox and other cosmetic treatments, for US$ 63 billion. While the companies are still awaiting regulatory approval for their deal, with US$ 49 billion in combined 2019 revenues, the merged entity would rank amongst the biggest in the industry. View Our Interactive Dashboard on Top drugs by sales in 2019 (Free Excel Available) The big five by pharmaceutical sales — Pfizer, Roche, J&J, Novartis and Merck Pfizer continued to lead companies by pharmaceutical sales by reporting annual 2019 revenues of US$ 51.8 billion, a decrease of US$ 1.9 billion, or 4 percent, compared to 2018. The decline was primarily attributed to the loss of exclusivity of Lyrica in 2019, which witnessed its sales drop from US$ 5 billion in 2018 to US$ 3.3 billion in 2019. In 2018, Pfizer’s then incoming CEO Albert Bourla had mentioned that the company did not see the need for any large-scale M&A activity as Pfizer had “the best pipeline” in its history, which needed the company to focus on deploying its capital to keep its pipeline flowing and execute on its drug launches. Bourla stayed true to his word and barring the acquisition of Array Biopharma for US$ 11.4 billion and a spin-off to merge Upjohn, Pfizer’s off-patent branded and generic established medicines business with Mylan, there weren’t any other big ticket deals which were announced. The Upjohn-Mylan merged entity will be called Viatris and is expected to have 2020 revenues between US$ 19 and US$ 20 billion and could outpace Teva to become the largest generic company in the world, in term of revenues.  Novartis, which had followed Pfizer with the second largest revenues in the pharmaceutical industry in 2018, reported its first full year earnings after spinning off its Alcon eye care devices business division that had US$ 7.15 billion in 2018 sales. In 2019, Novartis slipped two spots in the ranking after reporting total sales of US$ 47.4 billion and its CEO Vas Narasimhan continued his deal-making spree by buying New Jersey-headquartered The Medicines Company (MedCo) for US$ 9.7 billion to acquire a late-stage cholesterol-lowering therapy named inclisiran. As Takeda Pharmaceutical Co was busy in 2019 on working to reduce its debt burden incurred due to its US$ 62 billion purchase of Shire Plc, which was announced in 2018, Novartis also purchased the eye-disease medicine, Xiidra, from the Japanese drugmaker for US$ 5.3 billion. Novartis’ management also spent a considerable part of 2019 dealing with data-integrity concerns which emerged from its 2018 buyout of AveXis, the gene-therapy maker Novartis had acquired for US$ 8.7 billion. The deal gave Novartis rights to Zolgensma, a novel treatment intended for children less than two years of age with the most severe form of spinal muscular atrophy (SMA). Priced at US$ 2.1 million, Zolgensma is currently the world’s most expensive drug. However, in a shocking announcement, a month after approving the drug, the US Food and Drug Administration (FDA) issued a press release on data accuracy issues as the agency was informed by AveXis that its personnel had manipulated data which the FDA used to evaluate product comparability and nonclinical (animal) pharmacology as part of the biologics license application (BLA), which was submitted and reviewed by the FDA. With US$ 50.0 billion (CHF 48.5 billion) in annual pharmaceutical sales, Swiss drugmaker Roche came in at number two position in 2019 as its sales grew 11 percent driven by its multiple sclerosis medicine Ocrevus, haemophilia drug Hemlibra and cancer medicines Tecentriq and Perjeta. Roche’s newly introduced medicines generated US$ 5.53 billion (CHF 5.4 billion) in growth, helping offset the impact of the competition from biosimilars for its three best-selling drugs MabThera/Rituxan, Herceptin and Avastin. In late 2019, after months of increased antitrust scrutiny, Roche completed its US$ 5.1 billion acquisition of Spark Therapeutics to strengthen its presence in gene therapy. Last year, J&J reported almost flat worldwide sales of US$ 82.1 billion. J&J’s pharmaceutical division generated US$ 42.20 billion and its medical devices and consumer health divisions brought in US$ 25.96 billion and US$ 13.89 billion respectively.  Since J&J’s consumer health division sells analgesics, digestive health along with beauty and oral care products, the US$ 5.43 billion in consumer health sales from over-the-counter drugs and women’s health products was only used in our assessment of J&J’s total pharmaceutical revenues. With combined pharmaceutical sales of US$ 47.63 billion, J&J made it to number three on our list. While the sales of products like Stelara, Darzalex, Imbruvica, Invega Sustenna drove J&J’s pharmaceutical business to grow by 4 percent over 2018, the firm had to contend with generic competition against key revenue contributors Remicade and Zytiga. US-headquartered Merck, which is known as MSD (short for Merck Sharp & Dohme) outside the United States and Canada, is set to significantly move up the rankings next year fueled by its cancer drug Keytruda, which witnessed a 55 percent increase in sales to US$ 11.1 billion. Merck reported total revenues of US$ 41.75 billion and also announced it will spin off its women’s health drugs, biosimilar drugs and older products to create a new pharmaceutical company with US$ 6.5 billion in annual revenues. The firm had anticipated 2020 sales between US$ 48.8 billion and US$  50.3 billion however this week it announced that the coronavirus  pandemic will reduce 2020 sales by more than $2 billion. View Our Interactive Dashboard on Top drugs by sales in 2019 (Free Excel Available)  Humira holds on to remain world’s best-selling drug AbbVie’s acquisition of Allergan comes as the firm faces the expiration of patent protection for Humira, which brought in a staggering US$ 19.2 billion in sales last year for the company. AbbVie has failed to successfully acquire or develop a major new product to replace the sales generated by its flagship drug. In 2019, Humira’s US revenues increased 8.6 percent to US$ 14.86 billion while internationally, due to biosimilar competition, the sales dropped 31.1 percent to US$ 4.30 billion. Bristol Myers Squibb’s Eliquis, which is also marketed by Pfizer, maintained its number two position and posted total sales of US$ 12.1 billion, a 23 percent increase over 2018. While Bristol Myers Squibb’s immunotherapy treatment Opdivo, sold in partnership with Ono in Japan, saw sales increase from US$ 7.57 billion to US$ 8.0 billion, the growth paled in comparison to the US$ 3.9 billion revenue increase of Opdivo’s key immunotherapy competitor Merck’s Keytruda. Keytruda took the number three spot in drug sales that previously belonged to Celgene’s Revlimid, which witnessed a sales decline from US$ 9.69 billion to US$ 9.4 billion. Cancer treatment Imbruvica, which is marketed by J&J and AbbVie, witnessed a 30 percent increase in sales. With US$ 8.1 billion in 2019 revenues, it took the number five position. View Our Interactive Dashboard on Top drugs by sales in 2019 (Free Excel Available) Vaccines – Covid-19 turns competitors into partners This year has been dominated by the single biggest health emergency in years — the novel coronavirus (Covid-19) pandemic. As drugs continue to fail to meet expectations, vaccine development has received a lot of attention.  GSK reported the highest vaccine sales of all drugmakers with total sales of US$ 8.4 billion (GBP 7.16 billion), a significant portion of its total sales of US$ 41.8 billion (GBP 33.754 billion).   US-based Merck’s vaccine division also reported a significant increase in sales to US$ 8.0 billion and in 2019 received FDA and EU approval to market its Ebola vaccine Ervebo. This is the first FDA-authorized vaccine against the deadly virus which causes hemorrhagic fever and spreads from person to person through direct contact with body fluids. Pfizer and Sanofi also reported an increase in their vaccine sales to US$ 6.4 billion and US$ 6.2 billion respectively and the Covid-19 pandemic has recently pushed drugmakers to move faster than ever before and has also converted competitors into partners. In a rare move, drug behemoths  — Sanofi and GlaxoSmithKline (GSK) —joined hands to develop a vaccine for the novel coronavirus. The two companies plan to start human trials in the second half of this year, and if things go right, they will file for potential approvals by the second half of 2021.  View Our Interactive Dashboard on Top drugs by sales in 2019 (Free Excel Available)  Our view Covid-19 has brought the world economy to a grinding halt and shifted the global attention to the pharmaceutical industry’s capability to deliver solutions to address this pandemic.  Our compilation shows that vaccines and drugs for infectious diseases currently form a tiny fraction of the total sales of pharmaceutical companies and few drugs against infectious diseases rank high on the sales list. This could well explain the limited range of options currently available to fight Covid-19. With the pandemic currently infecting over 3 million people spread across more than 200 countries, we can safely conclude that the scenario in 2020 will change substantially. And so should our compilation of top drugs for the year. View Our Interactive Dashboard on Top drugs by sales in 2019 (Free Excel Available)   

Impressions: 54754

https://www.pharmacompass.com/radio-compass-blog/top-drugs-and-pharmaceutical-companies-of-2019-by-revenues

#PharmaFlow by PHARMACOMPASS
29 Apr 2020
Litigation free, first generic opportunities!
Wouldn’t it just be wonderful if there were opportunities to become the first generic on the market and not have to deal with patent litigation? Using the PharmaCompass database, we ran a check for products which are currently on market, without generic competition, however have no patents listed in the FDA orange book.  FDA is required by law to publish approved drug products and this publication is commonly called the Orange Book. While this may sound surprising, since almost all brand-name innovator drugs have patents listed in the Orange Book, we did find some multi-million dollar products without any patent listings.  The benefit of no patent listings No patent listings on the FDA orange book prevent the opportunity for the brand manufacturer to use a legal provision that delays the launch of a generic version of the product by up to 30 months.  Lowered litigation costs, increased probability of an early entry to market combined with a higher share of a multi-million dollar market are all the elements of a dream product launch.  The opportunities certainly seem too good to be true and our analysis came up with an interesting list of products which we have shared below. Lundbeck’s Sabril, a perfect example With almost $115 million in sales which grew at 35% in 2014, Lundbeck’s Sabril (Vigabatrin) had its non-patent, market exclusivity granted, by the FDA, to a new chemical entity expire last year.  The product is still protected by some other marketing exclusities granted for new patient populations (expiry 2016) and pediatric patients (expiry 2017), Sabril presents a perfect example where generics can anticipate windfall profits. However, some generic companies are already started  targeting the Sabril (Vigabatrin) opportunity based on our review of the export price data on PharmaCompass.  Lundbeck’s Onfi & Northera Interestingly Lundbeck has two other products, Onfi (Clobazam) and Northera (Droxidopa) also on the list. The exclusivity protection of Onfi is scheduled to expire next year and generic competition will be a setback for Lundbeck as Onfi brought in almost $150 million in sales in 2014, a 61% increase over 2013.   Droxidopa’s exclusivity protection runs out much longer (2019) as the product only obtained approval last year. However, Lundbeck has great hopes for this drug as it paid $658 million to buy the drug as soon as it was approved.   Polidocanol’s $500 million sales potential Polidocanol, used in the treatment of spider (varicose) veins, was first approved in 2010 under the brand name Asclera. No patents were listed in the Orange Book and the market exclusivity on the product expired in March this year.  In 2013, a new formulation of Polidocanol was launched by U.K. based, BTG International, and they expect to achieve sales of $500 million with the product. However, this time there are patents listed in the Orange book!   Other examples Diagnostic agents, like Dotarem (Gadoterate Meglumine), Choline C-11 and Lumason (Sulfur Hexafluoride Lipid Microspheres) are also examples of products which are covered by non-patent exclusivity protections. Dotarem, already approved in 70 countries, is used in magnetic resonance imaging (MRI) of the brain, spnine and associated tissues while Lumason helps physicians see the heart clearer when the ultrasound image is hard to see. The generic launch of Apotex’s Ferriprox (Deferiprone) in 2016 will be interesting since our database shows four potential challengers who have U.S. Drug Master Files submitted for the product. However, two of these four companies (Aarti Drugs & Emcure Pharmaceuticals) are on the U.S. FDA import alert list and hence banned from supporting a generic launch. Glaxo’s Potiga (Ezogabine) is Big Pharma’s representative on our list. The drug, used to treat certain types of epilepsy, when launched was expected to have sales between $200-800 million. The current sales have however been well below expectations as the drug was found to be associated with risks of skin discoloration and eye abnormalities. Uncommon business There are some drugs on this list which are for uncommon diseases.  Carglumic Acid and Miltefosine both address orphan drug populations, however, they have also made recent headlines. Carglumic acid is the most expensive drug per prescription dispensed in the United States.  Miltefosine, on the other hand, got approval for tropical diseases which almost never occur in the country!  Knight Therapeutics, which got awarded the approval was not really depending on the sales of the product. Along with the product approval they received a Neglected Tropical Disease Priority Review Voucher. The voucher reduces the review period of a new drug application from the standard 10 months to 6. Since blockbuster drugs make hundreds of millions of dollars in sales every month, a launch four months earlier could mean an extra few billion dollars in revenue.   Hence, it wasn’t surprising when in November 2014, Gilead Sciences purchased the voucher from Knight for $125 million. The next priority review voucher was sold, two months ago, for an incredible $245 million dollars, generating a new multi-million dollar business of developing products for diseases which have almost no patients!  Our View It is difficult to imagine that, with the stakes involved and the nature of the pharmaceutical business, there will be no litigation when a generic tries to take away market share from the innovator.  However, a list of products with no patents in the Orange Book does give generics new opportunities to think about.  

Impressions: 4983

https://www.pharmacompass.com/radio-compass-blog/litigation-free-first-generic-opportunities

#PharmaFlow by PHARMACOMPASS
23 Jul 2015
FDA Strikes More Than 40 Drugs Approvals In 2014
Unless you are like Voltaire and think that “The art of medicine consists of amusing patients while nature cures the disease”, you will be thrilled with the new drugs approval (NDAs) list of the FDA: about 40 new drugs in 10 therapeutic areas! It has been 18 years since the FDA approved so many new drugs, so let’s quickly take a tour at the Olympic podium:   OLYMPIC PODIUM The golden medal comes to AstraZeneca with 4 NDAs: Farxiga (diabetes), Movantik (constipation), Lynparza (ovarian cancer) and Myalept (lipodystrophy, also called fat reduction, which is common in patients with HIV and AIDS).  Then come the silver medals with 3 NDAs each: Biogen Idec with Alprolix (hemophilia B), Eloctate (hemophilia A), Plegridy (multiple sclerosis). Lilly with Cyramza (gastric cancer), Jardiance (diabetes), Trulicity (diabetes). Merck&Co with Zontivity (coronary artery disease), Belsomra (insomnia), Keytruda (melanoma). And the bronze medals with 2 NDAs each:  Boehringer-Ingelheim with Striverdi Respimat (chronic obstructive pulmonary disease), Ofev (idiopathic pulmonary fibrosis). Cubist with Sivextro (skin infection), Zerbaxa (urinary and abdominal infections). Gilead with Zydelig (leukemia), Harvoni (hepatitis C –“first combination pill approved to treat chronic hepatitis C virus genotype 1 infection and the first approved regimen that does not require administration with interferon or ribavirin”). Novartis with Xtoro (acute otitis externa), Zykadia (lung cancer). THERAPEUTIC AREAS  In terms of therapeutic areas, infectious diseases come first with 27% of the NDAs, followed by cancer with 18% and then rare diseases with 11% according to Forbes. Knowing that a disease is classified as ‘rare’ when it affects 200,000 people maximum in the US, the pharmaceutical industry and the FDA have done a fantastic job because overall it is 25 millions American whom are concerned by orphan diseases. And how many more around the world?  According to EvaluatePharma, in 2020 orphan drugs are expected to account for 19% of the total share of prescription drug sales excluding generics, reaching $176 billion in annual sales in America alone.   Here are the main NDAs 2014 for rare diseases: Amgen with Blincyto (Philadelphia chromosome-negative precursor B-cell acute lymphoblastic leukemia- leads to cancer). Anacor with Kerydin (fungal infection). BioCryst with Rapivab (influenza- infectious disease caused by the influenza virus). Biomarin with Vimizim (Morquio A syndrome- the body is missing or doesn't have enough of a substance needed to break down long chains of sugar molecules).  Boehringer-Ingelheim with Ofev (idiopathic pulmonary fibrosis).  Chelsea with Northera (neurogenetic orthostatic hypotension- often associated with Parkinson’s disease). Hoffman la Roche with Esbriet (idiopathic pulmonary fibrosis). Johnson & Johnson with Sylvant (multicentric Castleman’s disease- involves hyper activation of the immune system). Paladin with Impavido (leishmaniasis- disease caused by protozoan parasites). Sanofi with Cerdelga (Gaucher’s disease- genetic disease in which fatty substance accumulate in cells and certain organs). Spectrum with Beleodaq (non-Hodgkin lymphoma- group of blood cancers that includes any kind of lymphoma except Hodgkin's lymphomas). Takeda with Entyvio (ulcerative colitis ; Crohn’s disease- inflammatory disease that affects any part of the gastrointestinal tract from mouth to anus) Valeant with Jublia (fungal infection).  Vanda with Hetlioz (non stop 24 hour sleep wake disorder).   The huge impact after the release of the 2014 NDAs list was the pharma exchange-traded funds flared up (Nasdaq Biotechnology Index and S&P 500 Health Care Index 34 percent and 23 percent respectively. However, finance is not everything, as we have all learned during the 2008 financial crisis, and NDAs are not the only conditions for a new strategy to success anymore, as proven by a lot of pharmaceutical companies in the past years who haven’t achieved enough revenues despite NDAs.  It seems that pricing is going to be key as competition is becoming fiercer. Look at the 2014 NDAs batch for anti bacterial drugs to treat skin infections; 3 brand new drugs for this year only.  Cubist with Sivextro Durata with Dalvance The Medecine Companies with Orbactiv Same for the idiopathic pulmonary fibrosis as we just saw in the rare diseases approval list above: 2 NDAs for 2014. According to Fierce Pharma, there are 8 therapeutic areas where competition is going to be even fiercer in the future: hepatitis C, diabetes, cholesterol, hemophilia, hemo-oncology, psoriasis, melanoma and obesity. And it is not like patents are not going to continue dropping; generics represent now more than 40% of the products sales. Moreover, premium prices following NDAs have been implicating confrontations with insurers and governments in regards to diabetes and respiratory drugs in the past.  Therefore, new tactics have to be found!  AbbVie offered their new anti hepatitis C drug, Viekira Pak, at a discount price to Express Script (the largest pharmacy benefit management organization in the United States) for an exclusive distribution. Even if Viekira Pak is said to be a less convenient dosing regiment when compared to Gilead’s anti hepatitis C drug (Sovaldi), the deal was closed as Sovaldi’s premium price actually chocked the payers. It is a perfect move for AbbVie, who just lost their patent on one of their main drug: Humira (rheumatoid arthritis).  Biotech are said to be an excellent area for successful strategy as well.  If there is more success at R&D projects (as it looks to be the case in the biotech field) then R&D department cost less and the overall financial risk should be lowered.  Here are the main NDAs 2014 for biotech/ cancer:  Baxter with Obizur (hemophilia). Biogen Idec with Plegridy (multiple sclerosis), and Alprolix and Eloctate (hemophilia). Celgene with Otezla (psoriasis) Gilead with Zydelig (anti-cancer treatment). Helsinn with Akynzeo (emesis- prevent nausea and vomiting caused by cancer drug treatment).  Salix with Ruconest and Pfizer with Trumenba (meningitides type B). Bristol-Myers Squibb with Opdivo (melanoma) and Merck & Co with Keytruda (melanoma as well), which work by blocking a protein called Programmed Death receptor (PD-1), are the first in a coming wave of immunotherapies and are said to have the potential of generating more than 30 million USD/ year.       So in case all these new strategies don’t work and definitely become a financial matter only instead of a medical focus to help the world to live a little better, don’t forget to “always laugh when you can, it is cheap medicine” as George Gordon Byron liked to advise.    

Impressions: 2361

https://www.pharmacompass.com/radio-compass-blog/fda-strikes-more-than-40-drugs-approvals-in-2014

#PharmaFlow by PHARMACOMPASS
05 Mar 2015