Margin of victory crucial for Merck and Bayer’s vericiguat

Vericiguat, the guanylate cyclase agonist on which Bayer and Merck & Co are collaborating, has flown under the radar, but perhaps for no longer. The phase III Victoria trial succeeded, the partners said today, showing a reduction in the risk of heart failure hospitalisation or cardiovascular death versus placebo in chronic heart failure with reduced ejection fraction (HFrEF). The actual numbers remain crucial: according to Bernstein analysts a 15-20% risk reduction on top of standard of care, Entresto, will need to be seen. A similar reduction in patients not taking Entresto might not be good enough; patients in Victoria were taking vericiguat on top of their normal heart failure therapies but it is not clear how many were on the Novartis drug. The project is not currently seen as a major future source of sales for either company - the partners share economics 50-50 - though another pending study should help assess the potential. The phase II Vitality trial has recruited patients with preserved ejection fraction (HFpEF), a much tougher setting, and is assessing whether vericuguat can improve physical functioning. Results are due early next year and another successful read out could prompt another look at this low profile asset.

Vericiguat's forecast sales
    WW annual sales ($m)
Company First launch 2021e 2022e 2023e 2024e
Merck & Co Dec 2020 55 140 230 317
Bayer Dec 2020 13 34 72 118
Total   67 174 302 435
Source: EvaluatePharma.

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