Sales of Kisqali surge, Ibrance decline

Next-gen breast cancer treatment market undergo drastic changes

Market size KRW 92.6 billion last year... 7% YoY increase

Ibrance’s sales declined KRW 9.4 billion for the first time in 6 years since its release

Kisqali’s sales exceed KRW 20 billion... beats Verzenio

The market for cyclin-dependent kinases (CDK) 4/6 inhibitors that are used to treat metastatic breast cancer have undergone drastic changes last year.

 

Sales of Ibrance, which used to dominate the market, had faltered, while the latecomer Kisqali rapidly expanded its share in the market .

 

According to the market research institution IQVIA on the 8th, the domestic market for CDK 4/6 inhibitors increased 7.1% YoY from KRW 86.5 billion in the previous year to ₩92.6 billion last year.

 

CDK, cyclin-dependent kinases, control cell division and growth.

 

CDK 4/6 inhibitors selectively inhibit CDK 4/6 to suppress the proliferation of cancer cells.

 

These drugs are mainly used to treat hormone receptor (HR)-positive or human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer, which accounts for 60% of all breast cancers.

 

Since the introduction of the first-in-class CDK 4/6 inhibitor, Pfizer’s Ibrance (palbociclib), Novartis’s Kisqali (ribociclib), and Lilly’s Verzenio (abemaciclib) are also available in the market.

 

Ibrance, which overtook the market as the 'first-in-class' drug, experienced its first decline in sales last year.

 

Ibrance’s sales fell 14.3% YoY from the KRW 65.6 billion in the previous year to record sales of KRW 56.2 billion last year.

 

The drug, which had shown repeated growth since its launch, faced a decline in sales for the first time in six years.

 

The first CDK 4/6 inhibitor Ibrance was developed by Pfizer and released in Q4 2016 in Korea.

 

The drug offered a new treatment option for patients with HR+/HER2- metastatic breast cancer that were left to use chemotherapy for their disease that cannot be controlled with hormone therapies like aromatase inhibitors.

 

Upon its release, Ibrance was received with high expectations in the market, being the first drug to demonstrate a PFS of over 2 years.

 

Ibrance’s sales rose sharply from KRW 6.6.

 

billion in 2017 to KRW 25.3 billion in 2018, KRW 43.7 billion in 2019, and then KRW 57.3 billion in 2020.

 

The sales decline started with the introduction of its latecomers.

 

Kisqali and Verzenio entered the market in 2020 and started expanding their presence ever since.

 

Among the latecomers, Kisqali has been showing marked growth.

 

Kisqali’s sales rose 143.6% YoY from the KRW 9.7 billion earned in the previous year to record KRW 23.7 billion last year.

 

Although it had the lowest share of the market with annual sales of less than KRW 10 billion until 2021, its sales had risen to the KRW 20 billion range last year and exceeded Verzenio’s sales.

 

The fact Kisqali is the only treatment option among CDK4/6 inhibitors that can be used in premenopausal breast cancer patients seems to have contributed to its rapid growth.

 

Ibrance and Verzenio are only indicated for the treatment of postmenopausal women with metastatic breast cancer.

 

However, Kisqali demonstrated its effect in premenopausal patients in clinical trials.

 

Unlike in the West where premenopausal patients account for less than 30% of the patient population, these women account for 55% of the patient population in Korea, which explains the increased use of Kisqali.

 

However, sales of Verzenio, which have risen sharply in 2021, had also slowed down somewhat.

 

Verzenio’s sales increased 13.7% YoY from the KRW 11.2 billion in the previous year to KRW 12.7 billion last year.

 

Verzenio is seeking to expand its market base this year after it had become the only CDK4/6 inhibitor allowed for use in early breast cancer.

 

The Ministry of Food and Drug Safety additionally approved Vezenio as an adjuvant treatment for patients with HR+ /HER2- type lymph node-positive, early breast cancer at high risk of recurrence.

 

This is the first time a new drug was approved for early breast cancer after the approval of aromatase inhibitors.