Jun-21 Rx Recovery afoot
Transcript of Jun-21 Rx Recovery afoot
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Jun-21 Rx – Recovery afoot
Analysis of the June quarter TRx and price data show: i) Biosimilar penetration rates are stable but Amgen has slashed prices sharply in 3 biosimilars. ii) Big Pharma is faring better. iii) Oral solids under volume pressure in the March quarter return to growth in the June quarter.
Among companies: i) Sun’s specialty Rx growth gained further
momentum. IL-23s outpaced IL-17s, and Cequa is the fastest growing molecule. ii) Sun’s Absorica lost 35% volume in May and June. iii) Albuterol: Cipla has 14.8% share while Lupin’s share touched 9% in the first week of July. iv) Cipla is ramping up in gTecfidera followed by Dr. Reddy’s. v) Cadila’s mesalamine franchise is stable. vi) Lupin’s gaining share in gVimovo and gApriso, but losing in famotidine.
Volume pressures easing in US Gx
In Exhibit 1, we have tabulated the growth of top-20 dispensed generic products in
the US that show volume pressures seen in the March quarter have eased in the
June quarter. We believe the Gx industry could see ~6% volume decline in Q1FY22.
Sun’s Ilumya is the fastest growing biologic in plaque psoriasis. Cequa continues
to grow faster than Xiidra and Restasis. Absorica lost 35% volume in two months.
Albuterol: Cipla’s market share is 14.8% for Jun-21 vs. 13.5% in Mar-21 while
Lupin’s market share is 7% for June; weekly data show Lupin’s share touched 9%
in July. Albuterol market grew 2% YoY in Q1FY22.
Cadila’s share in Lialda dropped 400bps YoY and Sun’s by ~300bps as innovator
gained ~600bps. Asacol HD share stable at 92%. 11% share in gDoxil.
Cipla and Dr. Reddy’s have started to ramp up in gTecfidera. Cipla’s share at 11%
in June vs. Dr.Reddy at 6%; both gained at the expense of Teva and Amneal.
Lupin has ramped up well in Apriso (15% share); however, it lost a 10% share in
famotidine, and prices have also corrected ~25%.
Sub Head
FP Table Body
Biosimilars: Big players extend lead; price erosion steepening
Big Pharma (Pfizer and Amgen) continue to gain biosimilars market share faster
than others. In bRituxan and bHerceptin, Pfizer has overtaken several peers.
Biocon’s ramp-up continues to be gradual–bNeulasta market share is 8.3%, +20bps
QoQ and lower than the Jun-19 peak of 9.2%. In bHerceptin, market share is 8.7%
(+60bps QoQ); Amgen has maintained its leadership but Pfizer now has second
highest market share at 9%. Biocon’s share in bLantus stands at ~2.6%; glargine
market slid ~5% YoY in the June quarter—lower than 11% dip in the March quarter.
Amgen has become aggressive in pricing; it offers the cheapest product pegfilgastim
despite being the innovator (Exhibit 5), while in trastuzumab and bevacizumab its
price cuts have intensified (Exhibit 6).
India Equity Research Pharmaceuticals July 23, 2021
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Kunal Randeria Aashita Jain +91 (22) 6620 3040 +91 (22) 6623 3463 [email protected] [email protected]
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Oral solids volumes seeing improvement in Jun-21 quarter
The prescription data of top 20 oral solids dispensed in the US indicate that post
negative volumes in Mar’21 quarter, Jun’21 quarter has seen mid-single digit
growth. Jun’21 quarter has seen ~6% YoY growth, which is the highest in four
quarters. Drugs such as rosuvastatin, aripiprazole, sildenafil and ondansetron have
seen double-digit YoY growth while simvastatin, montelukast and clopidogrel has
seen lower negative growth.
Improvement seen in volumes in June quarter
Q1FY20 Q2FY20 Q3FY20 Q4FY20 Q1FY21 Q2FY21 Q3FY21 Q4FY21 Q1FY22
Atorvastatin 1% 6% 6% 14% 8% 3% 4% -3% 5%
Rosuvastatin 13% 19% 20% 28% 22% 16% 17% 8% 18%
Omeprazole -7% -2% 1% 9% 10% 4% 3% -5% -2%
Aripiprazole 1% 7% 8% 17% 14% 12% 13% 6% 11%
Pantoprazole 1% 5% 6% 14% 12% 8% 7% 0% 6%
Sildenafil Citrate 39% 32% 15% 10% 10% 10% 10% 14% 14%
Duloxetine Hcl 0% 4% 5% 11% 7% 2% 3% -3% 4%
Montekulast -2% 4% 4% 19% 3% -4% -5% -18% -5%
Norvasc -1% 4% 5% 13% 7% 2% 2% -6% 3%
Lexapro 0% 6% 6% 16% 11% 10% 11% 4% 12%
Gabapentin -1% 3% 3% 8% 5% 0% 3% -2% 4%
Simvastatin -15% -10% -9% -2% -5% -10% -9% -16% -10%
Losartan Potassium 5% 3% 12% 21% 16% 6% -1% -8% 2%
Ondansentron 6% 15% 11% -3% -1% -4% -10% 1% 16%
Tadalafil 16% 42% 40% 55% 39% 32% 28% 28% 31%
Seroquel -3% 2% 2% 10% 9% 7% 8% 1% 4%
Clopidogrel -7% -2% -1% 6% 1% -6% -6% -12% -4%
Pregabalin -9% -3% 5% 15% 16% 12% 9% 4% 9%
Coreg -5% 0% 1% 8% 2% -3% -2% -9% 0%
Source: Edelweiss Research, Bloomberg
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Biosimilars TRx Trends; big players continue to outperform
Big pharma companies with biosimilars (Pfizer and Amgen) continue to gain
market share faster than others. In bHerceptin, Pfizer entered ~4-5 months after
Biocon/Mylan and had a gradual uptick initially. However, in the June quarter
Pfizer gained ~340bps ms QoQ and overtook Biocon/Mylan (+60bps QoQ) to
become #2 in trastuzumab; Amgen has comfortable retained its #1 position. In
bRituxan, Pfizer has not only overtaken Teva but also expanded its market share
gap to Teva to ~900bps.
Barring pegfilgrastim and rituximab, the first launchers have comfortably
retained leadership.
Herceptin Rx continues to decline in double-digits. However, other biologics as
well as biosimilars continue to log growth.
Biocon’s ramp-up is gradual across molecules. In bLantus, it has a 2.6% market
share 9.5 months after launch. In the June quarter, it saw ~60bps QoQ
improvement.
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Except trastuzumab and glargine, all other molecules recording strong growth
Market Rx
(Institutional) Jun-20 Jul-20 Aug-20 Sep-20 Oct-20 Nov-20 Dec-20 Jan-21 Feb-21 Mar-21 Apr-21 May-21 Jun-21
Pegfilgrastim 1,01,190 93,326 88,325 94,710 94,426 99,651 1,12,655 96,863 98,358 1,11,979 1,06,572 1,02,372 1,17,206
- YoY growth (month) 14% -3% -6% 2% -3% 13% 18% 3% 13% 9% 8% 7% 16%
- YoY growth
(quarter) 4% -2% 9% 8% 10%
Infliximab 6,61,021 6,84,566 6,49,329 6,67,339 6,71,849 6,46,769 6,98,212 6,54,636 6,24,357 7,41,272 7,03,695 6,61,790 7,57,177
- YoY growth (month) 13% 1% 2% 7% 1% 8% 8% -1% 8% 13% 15% 10% 15%
- YoY growth
(quarter) -1% 3% 6% 7% 13%
Trastuzumab 1,59,386 1,42,900 1,34,372 1,40,486 1,24,511 1,15,347 1,31,693 1,09,208 1,11,976 1,18,379 1,12,369 1,04,340 1,17,810
- YoY growth (month) -15% -27% -31% -24% -35% -30% -31% -34% -25% -29% -22% -27% -26%
- YoY growth
(quarter) -25% -27% -32% -29% -25%
Bevacizumab 1,56,522 1,52,508 1,48,986 1,57,721 1,57,449 1,61,115 1,82,222 1,58,116 1,62,371 1,78,779 1,76,216 1,65,851 1,90,006
- YoY growth (month) 27% 14% 11% 21% 12% 30% 35% 14% 27% 21% 29% 22% 21%
- YoY growth
(quarter) 11% 15% 25% 20% 24%
Rituximab 1,64,141 1,58,245 1,54,043 1,57,214 1,62,964 1,73,563 1,83,807 1,54,077 1,55,696 1,79,587 1,79,349 1,72,857 1,96,261
- YoY growth (month) 9% 1% -2% 3% -3% 17% 15% -4% 8% 14% 43% 25% 20%
- YoY growth
(quarter) -10% 1% 9% 6% 28%
Insulin glargine 16,25,58
5
16,28,06
2
15,72,75
9
15,18,43
5
15,37,37
3
14,73,39
4
16,10,46
7
15,14,04
7
13,94,12
3
16,01,69
1
15,03,60
9
15,04,92
7
15,82,71
4
- YoY growth (month) 3% -4% -6% -5% -8% -6% -5% -10% -10% -14% -9% -4% -3%
- YoY growth
(quarter) -1% -5% -6% -11% -5%
Source: Edelweiss Research, Bloomberg
Neulasta (pegfilgrastim): Four biosimilars have 34.6% share vs. 35.7% in Mar’21
implying that biosimilar penetration plateaued in the quarter. This is surprising
as increased vaccination in the US and opening up of clinics should have led to
biosimilar share gains at the expense of Onpro market, which remains at 51.9%
(-40bps QoQ). (Exhibit 3).
1. Market leader Coherus’s market share decreased to 18.5% (-290bps QoQ),
after peaking at 24.6% in Sep’20.
2. Biocon’s Fulphila stood at 8.3% (+20bps QoQ); this is below the 9.2% peak
market share of June 2019.
3. Sandoz’s share increased to 7.7% (+160bps QoQ). Pfizer launched its
biosimilar in Dec-20 and has a modest 1.7% share.
Amgen has become aggressive in Neulasta pricing. As per Medicare Part B data, last
two quarters have seen double-digit QoQ price declines. With rising competition
Amgen has become aggressive in Neulasta
pricing. As per Medicare Part B data, last
two quarters have seen double-digit QoQ
price declines. With rising competition
(Fresenius will launch sometime this year),
realizations are likely to become challenging
in our view.
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(Fresenius will launch sometime this year), realizations are likely to become
challenging, in our view
Biosimilar penetration in pegfilgrastim
Source: Bloomberg, Edelweiss Research
Herceptin (trastuzumab): Five biosimilars have a 50.5% share versus a 45.2%
share in Mar’21 (Exhibit 4).
1. Biocon’s Ogivri share increased marginally to 8.7% (+60bps QoQ).
2. Pfizer showed the sharpest increase with 340bps improvement QoQ. It is now
the second largest player.
3. Teva and Merck have a low-single digit market share and saw modest market
share increases.
In the March quarter, Amgen’s US bHerceptin revenues were flat QoQ at ~USD130mn
despite exit market share increasing from 41% to 43%. The extent of price erosion
can be seen from YoY numbers – while volume increased 83%, revenue increased only
35%. It expects the trend seen in Q1CY21 to continue given high competition (5
biosims).
Biosimilar penetration in trastuzumab
Source: Edelweiss Research, Bloomberg
1.96.5
7.9
9.2
7.06.3 5.8 6.1
7.47.6 8.1
8.3
02
7
13
22
2629
31 30
3432
36 36
0
8
16
24
32
40
Jun
-18
Sep
-18
Dec
-18
Mar
-19
Jun
-19
Sep
-19
Dec
-19
Mar
-20
Jun
-20
Sep
-20
Dec
-20
Mar
-21
Jun
-21
(%)
Coherus (Udencya) Biocon (Fulphila) Biosimilar share
0.1
0.7
4.05.6
7.28.1 8.7
0 26
13
22
28
38
45
50
-5
5
15
25
35
45
55
Jun-19 Sep-19 Dec-19 Mar-20 Jun-20 Sep-20 Dec-20 Mar-21 Jun-21
(%)
Amgen (Kanjinti) Biocon (Ogivri)
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Lantus (insulin glargine): Besides the brand Lantus, there are two glargine
products – Lilly’s Basaglar and Biocon’s Semglee. Sanofi’s Lantus has a 70.8%
market share (excluding Toujeo in our calculations), flat QoQ.
1. Basaglar’s market share is 26.7% (-50bps QoQ). It had reached a peak share of
30% in Nov-19. Despite a lower share, its revenue has steadily gone up over
quarters until two quarters ago.
2. Biocon is slowly gaining traction and holds ~2.6% share nine months after
launch despite having the lowest WAC among glargine players. Management
has guided that the ramp-up will be slow in CY21 and catch up in CY22
depending on the formulary coverage.
Other molecules
1. Avastin (bevacizumab) continues to erode, and the pace of biosimilar
penetration that had slackened in the last few months has intensified again.
Total biosimilar penetration is 66%; Amgen holds 47% and Pfizer 19% share.
2. Rituxan (rituximab), that had also has seen biosimilar penetration rate slacken
in the past few months, saw higher penetration. Pfizer – No.2 entrant – is now
the leader with 33.2% share and Teva’s market share is 24%. This is impressive
considering Pfizer does not have Rheumatoid arthritis on its label, which in our
view, is ~one–third of the market. Total biosimilar penetration is 58.7%.
Biosimilar pricing getting aggressive
Medicare Part B is part of the US national health insurance programme that covers
outpatient care and preventive services, among others. Exhibits 5 and 6 contain the
payment amounts that will be used to pay for Part B covered drugs for the third
quarter of 2021 (Jul–Sep). Medicare Part B reimbursement rates for the Jul–Sep
quarter indicate:
QoQ price decline in biosimilars has steepened in a few molecules. In fact, it’s
not just biosimilars but also innovator biologics that have been aggressive with
pricing.
Neulasta and biosimilars: Innovator Amgen’s prices have declined 12% QoQ
(following a 9% QoQ decline last qtr) and 40% YoY; this is the second-highest
decline since biosimilars entered this molecule. This also widens the discount
(7.5%) of Neulasta to other biosimilars. Coherus prices have been flat, Biocon has
seen a 5% QoQ decline and Sandoz ~2%.
Herceptin and biosimilars: The pace of price decline intensified for the ‘more
expensive’ biosimilars. _Biocon’s Ogivri price increased 5% QoQ. However, other
biosimilars like Teva and Merck which were among the more expensive
biosimilars they suffered 19% QoQ and 10% QoQ price declines, respectively, and
thus narrowed the gap to other biosimilars. Amgen is now the cheapest
biosimilar as it saw a sharp 10% QoQ decline.
Other molecules: Remicade & biosimilars saw lower QoQ decline than previous
quarters while Avastin saw a similar decline. Biocon is expected to get
approval/launch bAvastin after plant inspection.
As we have been flagging, intensifying competition has led to continual price
declines in biosimilars. In several cases, despite no new players, prices have been
eroding 4–6% QoQ. Amgen, in particular, has been aggressive with prices; this
quarter has seen Amgen having the steepest price declines in all the molecules it is
present in and making it the lowest cost supplier.
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In our recent ‘US and EU pharma roundup’ we note players such as Amgen have seen
revenue declining in bHerceptin despite higher market share while Coherus is
expecting its bNeulasta revenue to go down YoY in CY21 despite steady-to-
increasing market share. Also note that bHerceptin Rx have been declining at ~30%
YoY over the last few months—while part of it can be explained by Covid-related
slowdown, the molecule class has been facing double-digit volume pressures for
long, even prior to Covid..
Average Selling Price (ASP) in Medicare Part B in USD
ASP Medicare Part B reimbursement
Sep-18 Dec-18 Mar-19 Jun-19 Sep-19 Dec-19 Mar-20 Jun-20 Sep-20 Dec-20 Mar-21 Jun-21 Sep-21
Neulasta (pegfilgrastim) reimbursement price for 0.5mg
Amgen (innovator) 393 391 390 388 377 369 355 332 317 298 257 234 206
Biocon 369 358 350 333 327 312 308 294 269 248 237 222
Coherus 358 359 347 337 322 302 287 268 251 252
Sandoz 317 306 298 277 271
Pfizer 337 314
Herceptin (trastuzumab) reimbursement price for 10mg
Roche (innovator) 104 104 107 107 107 107 106 104 102 100 98 94 91
Roche - Hylecta (innovator) 80 82 79 78 77 75 75 72 72
Amgen 91 91 82 81 79 72 66 59
Biocon 91 91 93 76 73 61 63
Pfizer 83 83 83 74 68 65
Teva 96 92 86 82 67
Merck 91 92 88 80 72
Remicade (infliximab) reimbursement price for 10mg
Remicade 84 79 77 72 65 63 57 56 51 48 45 42 41
Pfizer (Inflectra) 65 61 57 54 51 49 48 48 47 44 43 41 40
Merck (Renflexis) 69 64 62 59 55 53 52 50 49 45 42 41 40
Amgen (Avsola) 52 52 50 49
Avastin (bevacizumab) reimbursement price for 10mg
Roche (Avastin) 81 81 81 81 81 80 78 76 75 73 71
Amgen (Mvasi) 70 70 63 62 61 57 53 49
Pfizer (Zirabev) 63 63 62 59 57 55
Source: CMS, Edelweiss Research
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Price erosion (QoQ) in Medicare Part B
ASP Medicare Part B reimbursement ASP Medicare Part B reimbursement (QoQ price decline)
Sep-18 Dec-18 Mar-19 Jun-19 Sep-19 Dec-19 Mar-20 Jun-20 Sep-20 Dec-20 Mar-21 Jun-21 Sep-21
Neulasta (pegfilgrastim)
Amgen (innovator) 5% -1% 0% -1% -3% -2% -4% -6% -4% -6% -14% -9% -12%
Biocon n/a n/a -3% -2% -5% -2% -5% -1% -4% -9% -8% -5% -6%
Coherus n/a n/a n/a n/a 0% -3% -3% -4% -6% -5% -7% -6% 0%
Sandoz n/a n/a n/a n/a n/a n/a n/a n/a n/a -4% -2% -7% -2%
Pfizer
Herceptin (trastuzumab)
Roche (innovator) 3% 0% 3% 0% 0% 0% -1% -2% -2% -3% -2% -4% -3%
Roche - Hylecta (innovator) n/a n/a n/a n/a n/a 2% -3% -2% -1% -3% -1% -3% 0%
Amgen n/a n/a n/a n/a n/a n/a 0% -10% -1% -3% -8% -9% -10%
Biocon n/a n/a n/a n/a n/a n/a n/a 0% 3% -18% -4% -17% 5%
Pfizer n/a n/a n/a n/a n/a n/a n/a n/a 0% 0% -11% -8% -5%
Teva n/a n/a n/a n/a n/a n/a n/a n/a n/a -5% -6% -5% -19%
Merck n/a n/a n/a n/a n/a n/a n/a n/a n/a 1% -4% -9% -10%
Remicade (infliximab)
Remicade 1% -6% -3% -6% -10% -2% -10% -3% -8% -7% -6% -7% -2%
Pfizer (Inflectra) -7% -6% -7% -5% -6% -4% -3% 0% -1% -7% -2% -6% -1%
Merck (Renflexis) -2% -7% -4% -4% -8% -2% -3% -4% -2% -8% -6% -3% -3%
Amgen (Avsola) n/a n/a n/a n/a n/a 0% -3% -2%
Avastin (bevacizumab)
Roche (Avastin) n/a n/a n/a 0% 0% 0% -1% -1% -1% -3% -2% -4% -3%
Amgen (Mvasi) n/a n/a n/a n/a n/a n/a 0% -10% 0% -2% -7% -7% -8%
Pfizer (Zirabev) n/a n/a n/a n/a n/a n/a n/a n/a 0% -1% -4% -4% -4%
Source: CMS, Edelweiss Research
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Albuterol (USD900mn market): Cipla maintains comfortable lead
Mar’21 quarter witnessed one of the weakest seasons that saw volumes declining
13–15% between January to March. However, April was the last month of decline
and May onwards volumes showed a YoY uptick; May TRx grew 8% YoY while Jun
TRx grew 11% YoY.
Albuterol volumes recovered from May’21
Source: Bloomberg, Edelweiss Research
Cipla’s uptake in albuterol remains impressive. Cipla market share touched
15.1% in the week of 9th July while Lupin also made strong gains with market
share touching 9%. This is in-line with Lupin’s guidance that maret share would
pick up post resolution of device supply issues.
Cipla’s ramp-up has been faster than Lupin. 45 weeks after launch, Lupin has 9%
market share while Cipla had 12.7%. This is despite Cipla’s RLD having a much
smaller market and Lupin’s lau nch coincided with Perrigo’s withdrawal.
However, Lupin has started catching up after a lethargic start. In the last 6 weeks,
Lupin’s market share has risen from 5% to 9%.
The interchangeability among brands that we had seen earlier, has become more
evident after the Perrigo’s withdrawal. Teva has been the biggest beneficiary of
Perrigo’s withdrawal (same RLD – ProAir) followed by Cipla (Proventil RLD)
Prasco (AG of Ventolin) and ProAir brand has lost share.
In the last 15 months (post Cipla’s launch), Ventolin and its generics have lost
around 1200bps market share (from 44% to 32%). ProAir and generics have
gained ~400bps to 52% share while Proventil and generics have gained ~800bps
to 16%. The main reason is that Ventolin had only 1 AG in the market and no
other generic while ProAir and ProVentil had both AG as well as another generic.
Moreover, Cipla’s share gain in albuterol market has expanded the overall
Proventil category, indicating product interchangeability.
Overall albuterol TRx in this quarter is up ~2% YoY.
-40%
-20%
0%
20%
40%
60%
0
1,600,000
3,200,000
4,800,000
6,400,000
8,000,000
Ap
r-1
9
Jun
-19
Au
g-1
9
Oct
-19
Dec
-19
Feb
-20
Ap
r-2
0
Jun
-20
Au
g-2
0
Oct
-20
Dec
-20
Feb
-21
Ap
r-2
1
Jun
-21
Albuterol market TRx YoY growth (RHS)
Recovery
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Cipla is comfortably ahead of Lupin…
Source: Edelweiss Research, Symphony
…but Lupin ramped up sharply in last few weeks
Source: Edelweiss Research, Symphony
Proventil has gained significant market share from Ventolin
Source: Bloomberg, Edelweiss Research
0% 0%1%
3%4% 4%
3% 3% 4% 4%5%
7%6%
7%8%
9%
10%11%
12% 12%13% 14%
15% 15%
0%
4%
7%
11%
14%
18%
Jul-
20
Au
g-2
0
Sep
-20
Oct
-20
No
v-2
0
Dec
-20
Jan
-21
Feb
-21
Mar
-21
Ap
r-2
1
May
-21
Jun
-21
Lupin Cipla
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
02
-10
-20
20
22
-10
-20
20
11
-11
-20
20
01
-12
-20
20
21
-12
-20
20
10
-01
-20
21
30
-01
-20
21
19
-02
-20
21
11
-03
-20
21
31
-03
-20
21
20
-04
-20
21
10
-05
-20
21
30
-05
-20
21
19
-06
-20
21
09
-07
-20
21
Lupin weekly and monthly TRx (of total albuterol market)
48% 51%
44% 33%
8%16%
0%
20%
40%
60%
80%
100%
Jul-
19
Sep
-19
No
v-1
9
Jan
-20
Mar
-20
May
-20
Jul-
20
Sep
-20
No
v-2
0
Jan
-21
Mar
-21
May
-21
ProAir HFA and generic Ventolin and generic Proventil and generic
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Specialty: positive trends continue in Ilumya & Cequa
Ilumya: Ilumya, which was worst hit during the pandemic, has picked up growth.
1. Sun’s specialty recovery continued strongly in Q1FY22. Ilumya +38% QoQ (+18%
QoQ in Q4FY21); its IL-23 counterpart Skyrizi has grown at +28% QoQ.
2. Sun’s Ilumya becomes the fastest growing molecule in this class. Ilumya TRx
growth in Q1FY22 was at 101% YoY. Abbvie’s Skyrizi which was growing on
similar lines is now growing slower than Ilumya at 77% YoY, albeit on a higher
base.
Cequa: After volume dip seen in Jan’21 and Feb’21, Cequa clocked highest TRx in
Jun’21 with +79% YoY growth. For the quarter ended Jun’21, Cequa growth was
103%, ahead of Xiidra’s 28% and Restasis’ 11%. Cequa list price increased by 4%
in Apr’21 which reduces Restasis list price premium from ~22% in Jan’21 to 17%.
Restastis list price increased by 5% in Jan’21.
Absorica (~USD135mn pre-genericisation): Actavis which had settlement to
launch on 27-Dec-2020, received final approval in Mar’21 and launched generic
Absorica on 1-April 2021. Following Actavis, Upsher Smith launched its generic in
May’21. This led to ~35% YoY decline in Absorica TRx; however, excluding the LD
ramp-up the decline in high dose TRx was ~54% in May and June. ~38% of total
Absorica Rx comprises low-dose Absorica (Absorica LD).
Ilumya performance continues to improve
Source: Edelweiss Research, Bloomberg
341
493 533430
1021
1275
0
300
600
900
1200
1500
Apr-19 Jun-19 Aug-19 Oct-19 Dec-19 Feb-20 Apr-20 Jun-20 Aug-20 Oct-20 Dec-20 Feb-21 Apr-21 Jun-21
Retail TRx Insti TRx
Ilumya trajectory is picking up with Jun Qtr TRx growth at 38% QoQ/101% YoY. In Jun month, TRx grew 19% MoM; 102% YoY
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Ilumya becomes fastest growing molecule in IL-23 class
Source: Edelweiss Research, Bloomberg
Cequa seeing strong uptick in TRx growth
Source: Bloomberg, Edelweiss Research
Absorica TRx declining sharply post genericisation
Source: Bloomberg, Edelweiss Research
784 712 771 860 896 925 842 877 1083 1033 1103 1172 12351514
1808
24892988 2794
25292976
3267 31743454
3840 3696
4573
32143590
5046
6065
0
1500
3000
4500
6000
7500
Apr-20 May-20 Jun-20 Jul-20 Aug-20 Sep-20 Oct-20 Nov-20 Dec-20 Jan-21 Feb-21 Mar-21 Apr-21 May-21 Jun-21
Ilumya Total TRx Skyrizi Total TRx
. Ilumya +38% QoQ; its IL-23 counterpart Skyrizi has grown on similar lines (+28% QoQ).
6685
3840 43885351
5929 58816682
8095 82139562
8150 7875
9652 9101 88459583
0
3000
6000
9000
12000
15000
Mar
-20
Ap
r-2
0
May
-20
Jun
-20
Jul-
20
Au
g-2
0
Sep
-20
Oct
-20
No
v-2
0
Dec
-20
Jan
-21
Feb
-21
Mar
-21
Ap
r-2
1
May
-21
Jun
-21
CEQUA
Cequa clocked highest TRx in Jun'21 with 8% MoM growth.In Jun Qtr, Cequa TRx was 2x YoY as against 6-11% seen in other cyclosporines and 28% in Xiidra
0
3000
6000
9000
12000
15000
Oct
-19
No
v-1
9
Dec
-19
Jan
-20
Feb
-20
Mar
-20
Ap
r-2
0
May
-20
Jun
-20
Jul-
20
Au
g-2
0
Sep
-20
Oct
-20
No
v-2
0
Dec
-20
Jan
-21
Feb
-21
Mar
-21
Ap
r-2
1
May
-21
Jun
-21
TRx
Absorice high dose Absorica low dose
Edelweiss Securities Limited
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Mesalamines: Cadila holding fort; Sun share under pressure in
gLialda
In gLialda, Sun which was aggressively gaining market share at the expense of
Cadila has started to show signs of pressure. After achieving peak share of 12.4%
in Jan’21, Sun’s share has now slipped to 9%. Cadila’s market share too has
slipped from 55% to 51%. Surprisingly, innovator Takeda has gained at the
expense of both Cadila and Sun.
Asacol HD: Overall volumes down 6% YoY. However, the rate of decline has
eased – Mar’21 qtr saw ~13% YoY decline. Cadila’s market share has slipped from
~97% in Mar’21 to 92%. l
Apriso: Lupin has ramped up well with 15.5% market share, up 100bps QoQ.
Alkem has got US FDA approval for a generic version of Apriso and will be
launching shortly. Importantly, Alkem's Apriso ANDA is backed by its own DMF
i.e. it is backward integrated in this molecule. Apriso market size is $320mn as
per IQVIA, which could potentially translate to $200-220mn at the manufacturer
level, in our view. Currently there are 2 Authorised Generics (Lupin and Teva) and
1 generic (Mylan) in the market. Competition is likely to be limited and we expect
$25-30mn from this product at substantially higher margins.
Lialda: Cadila slipping share to 51%+ share; Sun also losing share
Source: Bloomberg, Edelweiss Research
40 45 47
53 58 59 59
55 55 56 53 54 52 53 55 56 54 52 51
- 1 2 2 2 1 1 3 3 4 8 8 10 12 12 10 8 8 9
0
15
30
45
60
75
Dec
-19
Jan
-20
Feb
-20
Mar
-20
Ap
r-2
0
May
-20
Jun
-20
Jul-
20
Au
g-2
0
Sep
-20
Oct
-20
No
v-2
0
Dec
-20
Jan
-21
Feb
-21
Mar
-21
Ap
r-2
1
May
-21
Jun
-21
Mar
ket
shar
e (%
)
ZYDUS SUN
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CDH market share slipped marginally to 92% in Asacol HD
Source: Bloomberg, Edelweiss Research
Lupin ramping up well in gApriso with 15.5% market share
Source: Bloomberg, Edelweiss Research
Other key drugs TRx
Dr.Reddy’s Suboxone market share is constant at 18%. Ciprodex market share
increased to ~29% (from 25%) as Sandoz grabs 67% share in Jun’21 (flat QoQ).
Market share plateauing in gKuvan tablets (three player market) with DRRD
share at 15% vs. Endo at 57%.
Dr. Reddy's market share in key launches
Market size at time of
launch (USD mn) Jun-20 Sep-20 Dec-20 Mar-21 Jun-21
Suboxone 1500 18% 18% 18% 18% 18%
Vimovo 410 26% 25% 27% 33% 42%
Syprine 400 0% 1% 19% 17% 10%
Colcrys 490 2% 2% 3% 4%
Ciprodex 450 18% 23% 25% 29%
Kuvan Tablets 150 15% 16% 13%
Source: Edelweiss Research, Bloomberg
Note: Market size is as per IQVIA data. At manufacturer level, the market size will be lower
0%
20%
40%
60%
80%
100%
Feb
-19
Ap
r-1
9
Jun
-19
Au
g-1
9
Oct
-19
Dec
-19
Feb
-20
Ap
r-2
0
Jun
-20
Au
g-2
0
Oct
-20
Dec
-20
Feb
-21
Ap
r-2
1
Jun
-21
ALLERGAN PLC. ZYDUS PHARMACEUTICALS, INC
0.6
4.0
6.4
9.810.7
11.7 12.2 12.3 12.9 13.314.2
15.616.5
15.5
0
4
8
12
16
20
May
-20
Jun
-20
Jul-
20
Au
g-2
0
Sep
-20
Oct
-20
No
v-2
0
Dec
-20
Jan
-21
Feb
-21
Mar
-21
Ap
r-2
1
May
-21
Jun
-21
Lupin market share (%)
Edelweiss Securities Limited
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Tecfidera (Dimethyl Fumarate): Despite 8 generic players, innovator Biogen
retains 56% market share (market size: ~USD 3.6bn pre-genericization). Among
Indian players Cipla and Dr.Reddy have ramped up aggressively in the last couple
of months. Surprisingly, the ms gains have come at the expense of Teva and
Amneal and not the innovator.
Cipla and Dr.Reddy ramping up in gTecfidera
Source: Edelweiss Research, Bloomberg
Copaxone: Mylan/Natco has gained 800bps market share to 49% in 40mg market
while Sandoz has ~5%. In the 20mg market, Mylan has 25% share while Sandoz
has 28%. 40mg prescriptions are ~65% of the total Copaxone. However, overall
copaxone volumes are on a constant decline. In Q1FY22, overall TRx declined by
20% YoY.
Doxil: Cadila had a slow start but has ramped up in Q1FY22 with 5% market share
in Mar’21 going up to 11% in Jun’21. Sun’s market share has gradually come
down from ~26% to 19% while Dr. Reddy’s share has come down from ~27% to
~23%.
Famotidine oral suspension: Famotidine oral suspension Rx have gone up 10x
from Sep-2019 following the FDA banning ranitidine in late Sep-2019 and
increasing use in Covid treatment protocol. Currently, Lupin is the market leader
with ca. 99% share in the oral suspension market; Perrigo and Cadila are other
players. Lupin could potentially be generating ca. USD75-80mn or 11-12% of its
US sales from this product, in our view. In May’21, Novitium received final
approval for famotidine oral suspension in the US. Cadila has also become
aggressive and has gone for a sharp 25% list price cut.
Lupin's market share has eroded ~10pp in 1 month...
31-03-2021 30-04-2021 31-05-2021 30-06-2021
Lupin 100 100 99 91
Cadila 0 0 0 6
Novitium 0 0 0 3
Source: Edelweiss Research, Bloomberg
1.2 1.1 1.31.7 1.7 1.8
3.3
7.8
10.4
1.10.5
0.0 0.1 0.2 0.3
2.3
5.05.9
0
3
5
8
10
13
Oct-20 Nov-20 Dec-20 Jan-21 Feb-21 Mar-21 Apr-21 May-21 Jun-21
Mar
ket
shar
e (%
)
Cipla Dr.Reddy
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...while price erosion is ~25%
Source: Bloomberg, Edelweiss Research
2.8
2.0
pre-Apr 2020 Apr-21
List price of famotidine suspension (USD)
Edelweiss Securities Limited
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Edelweiss Research is also available on www.edelweissresearch.com, Bloomberg - EDEL, Thomson Reuters, and Factset 17
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