↓Sales of Nexavar and Lenvima &↑Sales of Cabometyx

Liver cancer treatment market fluctuations

↓1Q Sales Nexavar 49% & Lenvima 41%

Nexavar, Lenvima, and Tecentriq

The second-line treatment Stivaga also decreased by 23%, and Only 2nd and 3rd line treatment Cabometyx grew by 11%.

 

Sales of major liver cancer treatments plummeted.

 

Nexavar (Sorafenib) sales decreased by nearly half in the first year, and Lenvima (Lenvatinib) sales also decreased by 41%.

 

It is analyzed that the impact of the immuno-oncology drug Tecentriq being added to the liver cancer first-line treatment market as a combination therapy with Avastin.

 

However, Cabometyx, which is used as a 2nd and 3rd line treatment, was the only one that showed an increase in sales.

 

In the case of second and third-line liver cancer treatment, it is analyzed that the limited coverage range is working in favor of Cabometyx.

 

Sales of Nexavar and Lenvima plummeted after the addition of Tecentriq’s first-line treatment.

 

According to IQVIA, a pharmaceutical market research institute, on the 26th, sales of Nexavar in the first quarter of this year were 1 billion won.

 

Compared to 2 billion won in the first quarter of last year, it decreased by half.

 

After launching in Korea in 2006, Nexavar was listed on the reimbursement list as a liver cancer treatment in 2008.

 

Since the introduction of Lenvima, sales of Nexavar have declined.

 

In the second quarter of 2021, when Hanmi Pharmaceutical released a generic Nexavar, the drug price was reduced and sales further decreased.

 

In May of last year, when Tecentriq received reimbursement for the first-line treatment of hepatocellular carcinoma through combination therapy with Avastin, the decline in sales increased further.

 

The situation is similar for Lenvima, which formed a competitive structure with Nexavar.

 

Since entering Tecentriq last year, the decline in sales has been evident.

 

Renvima's sales in the first quarter were 2.3 billion won, down 41% from 4 billion won in the first quarter of last year.

 

On the other hand, Tecentriq's growth rate is steeper after expanding its scope to the first-line treatment for liver cancer.

 

Tecentriq's sales, which were 18.4 billion won in the first quarter of last year, exceeded 20 billion won in the third quarter after the expansion of liver cancer benefits, and grew further to 23 billion won in the first quarter of this year.

 

Stivarga and Cabometyx, the second and third-line liver cancer treatments, had mixed feelings.

 

Stivarga decreased 23% from 3.6 billion won in the first quarter of last year to 2.8 billion won in the first quarter of this year.

 

On the other hand, Cabometyx increased by 11% from 4.7 billion won to 5.2 billion won.

 

It is the only treatment for liver cancer that has seen an increase in sales.

 

It is interpreted that the reason for the mixed results between Stivarga and Cabometyx, even though they are the same follow-up treatment, is due to the difference in efficacy between the drugs.

 

In 2020, Ipsen made an indirect comparison of the two drugs.

 

As a result of a one-to-one comparison of previously conducted phase 3 clinical data using a clinical matching-adjusted indirect comparison (MAIC) method, Cabometyx outperformed Stivarga in PFS by 5.6 months vs.

 

3.1 months.

 

Around the time this study was published, sales of Stivarga have been steadily declining.

 

Stivarga's sales, which were 6.1 billion won in the second quarter of 2020, decreased by half in about three years by the first quarter of this year.

 

On the other hand, Cabometyx increased by 58% from 3.3 billion won to 5.2 billion won during the same period.

 

Analysts say that the fact that reimbursement for second and third-line liver cancer treatment is limited is also working in favor of Cabometyx.

 

In the guidelines revised last year, the combination therapy of Tecentriq + Avastin is recommended as the first-line treatment for liver cancer.

 

If this fails, you can try a combination of Nexavar, Lenvima, Stivarga, Cabometyx, or another immuno-oncology drug.

 

However, in this case, benefits are not applied no matter what drug is used as a secondary treatment.

 

In the field of treatment, Nexavar is prescribed for non-reimbursement, followed by Stivarga or Cabometyx.

 

Stivarga and Cabometyx are approved for use only in patients previously treated with sorafenib.

 

It is analyzed that prescriptions are concentrated on Cabometyx in a situation where available drugs are limited after the failure of the first treatment.