Tecentriq, first immunotherapy reimbursed in liver cancer

...chases Keytruda’s lead

Succeeded in receiving first-line reimbursement for NSCLC from May, following Keytruda’s approval

First immunotherapy to be reimbursed for liver cancer… in combination with Avastin

Sold ₩67 billion last year… Challenges the ₩200 billion grossing Keytruda’s stronghold in the market

Roche’s Tecentriq(atezolizumab) became the first cancer immunotherapy to be approved for reimbursement in liver cancer.

 

Analysts have assessed that it had prepared the footsold to expand its sales with the first expansion in its scope of reimbursement in 3 years since 2019.

 

Tecentriq is continuing its stride to overcome the stronghold of Keytruda, the current leader in the cancer immunotherapy market.

 

The National Health Insurance Service had preannounced the posting of the ‘Revision to the notice for drugs prescribed and administered to cancer patients’ that contains a new category created to establish reimbursement standards for Tecentriq in liver cancer.

 

The reimbursement will be applied from May 1st.

 

According to the amendment, Tecentriq will be reimbursed as monotherapy in first-line for patients with metastatic NSCLC whose tumors are PD-L1 positive (TC≥50% or IC≥ 10%) and do not have EGFR of ALK mutations.

 

Also, the drug will become the first immunotherapy to be approved for liver cancer (patocellular carcinoma, HCC).

 

Among patients with advanced or unresectable hepatocellular carcinoma (HCC), those satisfy all of the following conditions: ▲who are Stage III or higher ▲Child-Pugh class A and ▲have a ECOG PS (performance status) 0-1, may receive reimbursement for Tecentriq in the first-line in combination with Avastin (bevacizumab).

 

The drug is approved for reimbursement for basically one year in liver cancer, and when no clinical results are announced on the optimal period of administration within the year, reimbursement can be approved for up to 2 years at the most.

 

As a latecomer in cancer immunotherapy, the company has been hurrying to extend its reimbursement to expand its share in the market.

 

Although the agenda had made slow progress after passing the Cancer Drug Deliberation Committee in February last year, the agenda gained momentum this year and was finally approved after 1 year and 2 months.

 

Source: IQVIA

In terms of reimbursement, Tecentriq’s scope has neared that of the immunotherapy leader Keytruda.

 

Keytruda currently owns the broadest indication among all cancer immunotherapies.

 

The drug was approved for 18 indications in 14 cancer types including lung cancer, head and neck cancer, melanoma, and gastric cancer.

 

However, among the approved indications, Keytruda is only reimbursed for NSCLC, Hodgkin lymphoma., and melanoma.

 

It took the drug 4 years just to extend the scope of reimbursement (both monotherapy and combination therapy) to first-line from second-line in NSCLC.

 

This goes to show how difficult reimbursement extensions are for the costly immunotherapies.

 

Roche has been expanding its reimbursement relatively quickly by actively accepting government proposals.

 

It succeeded in entering reimbursement in one year since its approval, and in 2019, it became the first immuno-oncology drug to remove the PD-L1 expression rate restriction and broaden its scope of reimbursement.

 

Based on this, Tecentriq posted ₩67.2 billion in sales last year based on the drug research institution IQVIA.

 

This is an 81.6% increase from the ₩37 billion made in the previous year.

 

It is only one-third of the sales of Keytruda, which is posted nearly ₩200 billion won, but Tecentriq’s sales are increasing at a rapid pace.

 

The drug significantly narrowed its gap with Opdivo (₩85 billion), the runner-up in the market.

 

The extended reimbursement approval this year has laid the grounds for Tecentriq’s sales expansion.

 

In particular, Tecentriq is the only drug that entered reimbursement among cancer immunotherapies, and is expected to bring a significant impact on the drug’s sales growth.

 

The Tecentriq and Avastin combination extended the survival period of liver cancer patients by about 6 months compared to Nexavar (sorafenib), the only first-line drug that had been available for 10 years.