The PD-1/L1 ( Programmed Death-1/Ligand 1) market that is already saturated is likely to become even more competitive with many new immune-oncology medications, specifically coming from China. Bristol Myers Squibb, the company manufacturing Opdivo is on alert for this upcoming challenge.
Although Bristol Myers Squibb is not insecure about the new PD-1/L1 rivalry, the chances of commercialization may be a greater issue, as the new competitors depreciate the existing drug price, which “we need to stay on top of” according to Chris Boerner, a chief commercial officer of the company.
Within the next 3 years, at least 3 PD-1s made by China are expected to launch in the United States with Eli Lilly, Novartis, and Coherus Biosciences as the U.S. partners. Even though neither of the drugs has emerged to be better than drugs available nowadays, the newcomers might be offering lower prices to achieve market value.
According to Boerner, BMS is keeping an eye on the upcoming drugs, however, it isn’t worried about the rivalry on merit. A price-based war could be damaging.
Commercialization is not solely affected by the low price, according to Boerner. Patients, doctors, and payers should also evaluate whether or not the drugs are equivalent.
“The risk of both of these things coming together likely varies by geography, healthcare system, and maybe even by therapeutic setting, but we pay very close attention to this,” he said. At least for now, the greatest risks don’t overlap with Opdivo’s largest markets, he added.
Of the seven available PD-1/L1 targeted inhibitors, Opdivo is the second most selling brand. The demand for the drug has recently been snagged due to competition with Keytruda, the market-leading drug of Merck and Co. It made $1.72 billion in revenue in the first phase, dropping 3% year to year, following a similar drop in 2020, and Bristol accused Covid-19 of being a cause of this drop. The drug has a less double-figure market share in the most important indication and is used in the first-line treatment of non-small cell lung cancer, in the United States.
The company stated that Opdivo would begin to rise again during this year, as a result of the plan of generating more information and getting market approvals which would enable the drug to protect itself in the competition.
These involve a combination with Exelixis’ Cabometyx in kidney cancers, along with the future release in post-surgery muscle-invasive bladder cancer and esophageal cancer.
Many PD-1/L1 innovators are waiting for approvals of the combination therapies in patients recently diagnosed with metastatic cancer. According to Boerner, the sales of this combo therapy will slope up gradually, even though it gained approvals.
Bristol will be introducing a third targeted inhibitor shortly. The combination of LAG-3 antibody retalimab and Opdivo has recently surpassed the sale of Opdivo alone as the first-line therapy for melanoma.
Nowadays, the combo of Opdivo-Yervoy accounts for 35%-40% of the first-line melanoma care, while single drug IO accounts for the remaining 30%. According to Boerner, the company is planning to hit the market with retalimab.
Samit Hirawat, Bristol’s Chief Medical Officer said that the company has initiated an early study combining chemotherapy with Opdivo-relatlimab combination, to launch a phase 3 trial this year. In addition to that, Bristol has just revealed 2 CAR-T cell therapies, including CD19- targeted drug Breyanzi and Abecama that target BCMA receptors. Both drugs need specialized targeted centers for administration.
In the first phase, Bristol’s revenue increased by 3% year to year to $11.1 million. Revlimid, a drug for multiple myeloma, stood first with a revenue of $2.94 billion, accompanied by Eliquis, a blood-thinning agent, that brought in $2.89 billion. Both drugs showed signs of progress.