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Avastin’s Q1 sales drop sharply… future sales prospects?
by May 25, 2022 05:47am
Roche’s blockbuster anticancer drug ‘Avastin (bevacizumab) has recorded the lowest quarterly sales in 5 years. The drug had been much influenced by the drug price cut that followed the introduction of its biosimilars. However, whether the drop will continue remains to be seen due to the rise of new variables from the additional price cut applied recently, the indication expansion to liver cancer, and the possibility of intensified competition among biosimilars this year. ◆Avastin’s sales drop sharply for 2 consecutive quarters… due to a 30% price cut According to the pharmaceutical market research institution IQVIA, Avastin’s sales in Q1 this year were ₩19.3 billion, a 32.6% YoY decrease from the ₩28.7 billion it made in the same period last year. Avastin is a blockbuster drug that has made ₩100 billion in annual sales over the past 5 years. Avastin inhibits VEGF, the main protein involved in inducing angiogenesis to create an antitumor effect. It is used in various cancer types including breast cancer, non-small cell lung cancer, renal cell carcinoma, and ovarian cancer. Avastin’s sales, which recorded ₩92 billion increased to ₩104.5 billion in 2018, and then ₩119.3 billion the next year. However, sales fell to ₩118.1 billion in 2020 and then dropped 4.9% last year to record ₩112.3 billion. Avastin's sales decline began in earnest in Q4 last year. Avastin's sales, which reached ₩30.9 billion in Q3 last year, fell 27.2% to ₩22.5 billion in Q1 this year. Then, in the first quarter of this year, it fell to ₩19.3 billion. This is the first time Avastin’s quarterly sales recorded less than ₩20 billion in the past five years. The sales drop was greatly influenced by the price cut that was made due to the introduction of its biosimilars. Samsung Bioepis received approval for the first Avastin biosimilar ‘Onbevzi’ in March last year and entered the market in earnest after being listed for insurance reimbursement in September. With Onbevzi’s listing, Avastin’s price ceiling fell 30% in October last year. Price of Avastin 0.1g/4mL fell from ₩330,387 to ₩231,271 and Avastin 0.1g/16mL fell from ₩1,077,531 to ₩752,746, respectively. In other words, the company received a sales hit corresponding to the 30% price cut. Avastin’s sales drop increased greater with Onbevzi generating ₩1.8 billion in sales in Q1 this year, and Samsung Bioepis is attempting to expand its market and signed a co-promotion agreement for the sale of Onbevzi in Korea. Onbevzi’s price was set at 63% of Avastin’s price, at ₩208,144 (0.1g/4mL) and ₩677,471 (0.4g/16mL). ◆Reimbursement expansion, additional price cuts, intensified competition….entangles the bevacizumab market Although Avastin’s sales dipped in the recent 2 quarters, whether the drop will continue remains unknown. For one, Roche received reimbursement approval for the combination of Avastin and its cancer immunotherapy ‘Tecentriq’ in liver cancer. In addition, other variables such as the additional price cuts, difference in price with its biosimilars, entry of additional competitors, etc had risen recently. On April 29th, the Ministry of Health and Welfare assigned reimbursement standards for the Tecentiq+Avastin combination therapy in the first-line treatment of hepatocellular cancer. This is the first time reimbursement was applied to a combination therapy that uses cancer immunotherapy in liver cancer. The Tecentiq+Avastin combination therapy may now be used as a first-line treatment option with other existing first-line treatments – Nexavar and Lenvima. This reimbursement extension has laid the foundation for Avastin to rebound in sales. Also, the reimbursement extension had made Avastin’s drug price similar to its biosimilars. With insurance benefits extended to liver cancer, the price ceiling of Avastin has been reduced by an additional 5% since October last year. From this month, the price ceiling of Avastin will be ₩218,782 (0.1g/4mL) and ₩712,098 (0.4g/16mL). The price difference between the 4mL doses is only ₩1,638 and ₩34,627 for the 16 mL dose. This reduced gap in price is analyzed to have decreased the biggest strength held by its biosimilars – the price competitiveness. On the other hand, Avastin’s biosimilar market has been unfolding in a more complex manner. The industry prospects are that Pfizer's Zirabev which was approved in May last year, and Alvogen’s Alymsis which was approved in January will join in the competition this year. On top of that, Celltrion also applied for permission for its 'CT-P16' in October last year. The Avastin biosimilar market, which had only one product, has quickly formed a multilateral competition structure. In particular, each of the Avastin biosimilars is showing a difference in price and its indications, and some biosimilar developers are in a patent dispute with the original company over some indications, including ovarian cancer. Recently, Alvogen lost to Roche in one patent invalidation trial. Its impact on the original Avastin will vary depending on the outcome of further lawsuits.