Erleada chases leader Xtandi in prostate cancer mkt

Astellas Xtandi Q3 sales KRW 11.7 billion…53% increase in a year

Janssen's Erleada's quarterly sales reach KRW 4.8 billion in only half a year since reimbursement listing earlier this year

Zytiga sales slow down...Janssen chases Xtandi sales with its follow-on Erleada

Pic of Astella

Astellas Pharm Korea ‘Xtandi (enzalutamide)’ took the lead among oral androgen receptor targeted agents (ARTAs) used to treat prostate cancer.

 

In comparison to declining sales of Janssen's ‘Zytiga (Abiraterone),’ sales of Janssen's other prostate cancer drug ‘Erleada (Apalutamide)’ has been rapidly increasing since being released just 6 months ago, chasing Xtandi in the market.

 

Xtandi's Q3 sales KRW 11.7 billion…top among ARTAs for prostate cancer The ARTA-type prostate cancer treatment, Xtandi, posted KRW 11.7 billion in sales in Q3.

 

According to IQVIA, a pharmaceutical industry research institute, this represents a 53% increase from the KRW 7.6 billion it had raised in the same quarter last year.

 

Xtandi is approved for ▲the treatment of asymptomatic or mildly symptomatic metastatic castration-resistant prostate cancer (mCRPC), ▲mCRPC previously treated with docetaxel, ▲high-risk non-metastatic castration-resistant prostate cancer, and ▲hormone-sensitive metastatic prostate cancer (mHSPC) in combination with androgen deprivation therapy (ADT).

 

It was approved in Korea in June 2013 and received reimbursement in November following year.

 

Recently, Xtandi's sales have increased sharply, especially since Q3 last year.

 

Previously, its sales ranged around KRW 6 billion, but this significantly increased to KRW 7.6 billion in Q3 last year, then to KRW 8.7 billion in tQ4, KRW 10.5 billion in Q1 this year, and KRW 11 billion in Q2.

 

The increase in sales last year is attributed to the expanded reimbursement.

 

In August, selective reimbursement was granted for the use of ADT as combination therapy for patients with progressive prostate cancer accompanied by distant metastasis.

 

Starting this November, reimbursement for ADTs were extended and is applied regardless of the use of other androgen-production-suppressing drugs.

 

Despite a 3% reduction in the insurance price due to its increased usage, its increase in prescriptions is said to have offset this decrease.

 

Quarterly sales of major ARTA prostate cancer treatments (Unit: KRW 100 mil, Data: IQVIA)

Zytiga sales 'slow down'...Erleada sales reach KRW 4.8 billion in only half a year ' Zytiga, a previous competitor of Xtandi, has recently shown a decline in sales.

 

Zytiga's sales in the last quarter were KRW 4.8 billion, a 14% decrease from KRW 5.6 billion of the previous year.

 

Since 2021, Zytiga had closely chased Xtandi in terms of sales.

 

In Q1 2021, sales of Xtandi and Zytiga were KRW 7.6 billion and KRW 2.9 billion, respectively, which is a 2.7 times difference.

 

By Q1 2022, this gap narrowed to 1.2 times, with sales reaching KRW 6.4 billion for Xtandi and KRW 5.2 billion for Zytiga.

 

The sales difference between the 2 drugs further decreased to less than KRW 1 billion in Q2 that year.

 

However, Zytiga's sales have continued to remain in the range of KRW 5 billion since then.

 

Meanwhile, Xtandi's sales increased rapidly.

 

From Q2 his year, the sales difference between the two drugs doubled.

 

Pic of Janssen

Janssen's new ATRA-type prostate cancer treatment, Erleada, has rapidly increased its sales since its introduction.

 

In December 2020, Erleada was approved as Janssen's third ATRA prostate cancer therapy.

 

It was added to the reimbursement listing in April this year.

 

Following the listing, Erleada generated sales of KRW 2.7 billion in the second quarter and increased to KRW 4.8 billion in the third quarter, marginally surpassing the sales of Zytiga.

 

Therefore, Janssen plans to focus on Erleada as a latecomer follow-on drugs to Zytiga, aiming to challenge the market leader Xtandi.

 

The market stirrer would be the change in the patient co-payment rates for Xtandi and Zytiga, and the generics development by domestic pharmaceutical companies.

 

Last month, the co-payment rates for Xtandi and Zytiga were adjusted from 30% to 5%.

 

This change occurred following the listing of Erleada, the third ARTA prostate cancer therapy, at a 5% co-payment rate.

 

The maximum reimbursement amount (listed price) for Xtandi was adjusted in the process.

 

Xtandi was registered as a subject to essential reimbursement through a risk-sharing agreement (RSA).

 

With expanded reimbursement, the listed price per tablet was reduced from KRW 28,820 to KRW 14,170.

 

This will be reflected after the fourth quarter of this year.

 

The release of a Zytiga generic by a domestic pharmaceutical company is also anticipated to significantly influence the competitive ground.

 

Hanmi Pharm launched Abiraterone, a generic of Zytiga, under reimbursement in October.

 

As a result, the price of Zytiga was reduced by 30%, from KRW 16,780 to KRW 11,746 per tablet.

 

This price reduction is expected to be reflected in sales after the fourth quarter of this year, potentially resulting steeper decline in Zytiga's sales.