Darzalex and Keytruda win 2016’s sell-side popularity contest

Even the world’s biggest drug makers can see their fortunes turn on the prospect for individual products, and last year was no exception. While Johnson & Johnson and Merck & Co were buoyed by growing hopes for their cancer therapies, Darzalex and Keytruda, Vertex and Novartis were damaged by concerns over the prospects for Orkambi and Entresto, for cystic fibrosis and heart failure.

These four drugs each saw consensus sales forecasts rise or fall by more than $2bn across 2016. These are huge shifts even for blockbuster products and rank as the largest last year, though a look atEvaluatePharma data reveals several other therapies that saw big swings in outlook (see tables below).

The analysis was constructed using archived sell-side consensus sales forecasts for 2020, ranked to show the biggest movements up and down.

Five biggest upgrades to marketed assets over the past 12 months 
Product Company Therapy area 2020e sales ($bn) 12-mth change ($bn)
Darzalex Johnson & Johnson Anti-CD38 multiple myeloma antibody 3.71 2.55
Keytruda Merck & Co Anti-PD-1 cancer antibody 6.61 2.11
Eliquis Bristol-Myers Squibb Oral anti-coagulant 6.15 1.90
Ibrance Pfizer Breast cancer; cyclin inhibitor  4.95 1.64
Revlimid Celgene Multiple myeloma; immunomodulator 11.80 1.61

The successful launch of Darzalex, fuelled by highly impressive data in multiple myeloma, emboldened the sell-side to substantially lift estimates for the antibody last year. With its more mature franchises slowing it is hugely important to J&J that the drug, licensed from Denmark’s Genmab, live up to these expectations.

Interestingly Revlimid, now standard of care in this blood cancer and other related malignancies, also received big upgrades. Celgene’s tight grip on this space is clearly not seen as a hindrance to others, although the increasingly competitive field and huge price tags of these therapies means this field will remain closely watched.

Elsewhere, the battle between the first anti-PD-1 checkpoint inhibitors has been well documented, and Bristol-Myers’s fall from grace is clear in these numbers. Comfort can perhaps be found for the New York company in Eliquis, upgrades for which more than compensate for Opdivo’s downgrades. After a slow launch the blood thinner seems to have finally gained traction.

Cancer is well represented in both halves of this analysis. Pfizer’s Ibrance has been a huge success story for the pharma giant; the first cyclin inhibitor to reach the market in breast cancer achieved sales of more than $2bn in 2016, its second year on the market, although competition in the class will emerge this year.

Looming competition is largely responsible for Xtandi’s downgrades, largely in the shape of J&J’s apalutamide, which is due to yield pivotal data in the next few months. And while this issue is also impacting NovoRapid, that product has also been hobbled by the pricing headwinds that have pressured the whole insulin space.

Five biggest downgrades to marketed assets over the past 12 months 
Product Company Therapy area 2020e sales ($bn) 12-mth change ($bn)
Orkambi Vertex Cystic fibrosis therapy 3.19 -2.26
Entresto Novartis Heart failure therapy 3.09 -2.23
Xtandi Astellas Anti-androgen; prostate cancer 4.08 -1.32
NovoRapid Novo Nordisk Fast-acting insulin 2.56 -1.23
Opdivo Bristol-Myers Squibb Anti-PD-1 cancer antibody 7.13 -1.22

The biggest downgrades last year were reserved for Orkambi and Entresto, relatively new products that saw longer term forecasts shaved as launches disappointed. However while Novartis is much more than its new heart failure pill and can weather the storm, Vertex has been punished for its reliance on its cystic fibrosis franchise and has come under pressure to diversify.

Much the same criticism has been levelled at Gilead, which is analysed more closely below. Several of the company’s products did feature in the top five fallers and risers but as much of this was down to cannibalisation of older products, rather than new sales per se, the company’s key hepatitis C and HIV franchises have been taken as a whole.

Gilead's results yesterday made clear that hepatitis C is a therapy area in decline and it appears the sell-side agrees – EvaluatePharma forecasts indicate that the market peaked in 2015, at $24bn in global sales. HIV meanwhile is seen growing out to at least 2022.

Overall, though, the company’s top line is shrinking, and Gilead executives are under pressure to act (Buying growth is a tricky choice for Gilead, February 8, 2017). The sector’s biggest growth drivers detailed here are almost definitely out of its reach, but investors are no doubt hoping to see products that can make a quick impact bought into the fold.

Spotlight on Gilead
2020e sales ($bn) 12-mth change ($bn)
Hepatitis C franchise  7.74 -3.14
HIV franchise  15.57 2.22

To contact the writer of this story email Amy Brown in London at [email protected] or  follow @ByAmyBrown on Twitter.

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