Will P-CABs take over PPIs in GERD treatment market?

Attention focused on whether and when Vocinty will be released … Takeda “will not disclose specific plans”

Daewoong’s Fexuprazan to follow HK Inno.N’s K-Cab

With HK Inno.N’s K-Cab increasing its influence in the potassium-competitive acid blocker (P-CAB) market, the introduction of new P-CAB products raises the question of whether the products may increase the P-CABs' share in the market.

 

In addition to Daewoong Pharmaceutical’s Fexuprazan, which is expected to be approved in Korea within this year, there are expectations that the already-approved Takeda Pharmaceuticals Korea’s Vocinty (vonoprazan) may also be released this year.

 

Since its introduction, P-CABs were regarded as the next-generation drug that would replace proton pump inhibitors (PPIs) in the market.

 

P-CABs have been known to have resolved most of PPIs' limitations, including the slow onset of action, varied effect according to mealtime, inter-individual variability according to CYP2C19 genotype, and drug interaction concerns.

 

In particular, HK Inno.N’s K-Cab is the world's first P-CAB that received approval for all major indications of gastric acid blockers including erosive and non-erosive Gastroesophageal reflux disease (GERD), It has 4 indications in total.

 

Although reimbursement is not applied to all four indications yet, K-Cab has shown clear growth every year after preoccupying Korea’s P-CAB market.

 

According to the pharmaceutical market data research firm UBIST, since recording 29.8 billion won in sales in 2019, K-Cab’s sales have more than doubled last year to record 72.6 billion won.

 

Also, just in the first quarter of 2021, it already recorded sales of 22.5 billion won.

 

Simple calculations show that if K-Cab’s sales continue at a similar level, the company may surpass 100 billion won in sales this year.

 

However, the industry's prevailing view is that it will take more time to see a shift in the overall market, given that the sales of PPIs are still record around 200 billion won.

 

This is why some predict that if Daewoong Pharmaceutical’s Fexuprazan is approved and released in Korea in the current environment, the rivalry between the two products may actually expand the P-CAB market.

 

An official from A Pharmaceuticals said, “It seems that HK Inno.N’s also knows that the overall share of the pie, the market share of P-CABs in general needs to be expanded to shift the market trend from PPIs to P-CABs.

 

Just like how the PPI market grew due to the introduction of many products in its class, Daewoong Pharmaceutical’s entry into the P-CAB market with its strong sales power will certainly make some waves in the current market situation.” In other words, the rivalry between HK Inno.N and Daewoong’s products may bring synergy in their market.

 

Another product receiving attention in this context is Takeda Pharmaceuticals Korea’s Vocinty.

 

Vocinty, known as the originator of this class of next-gen GERD treatment, was approved in March 2019, but no clear news on its release has been shared yet.

 

An official from Takeda Pharmaceuticals Korea said, “We are working to provide innovative medicines to patients according to our decision-making priorities.

 

However, we cannot disclose specifics on whether or not and when certain products will be released." However, with K-Cab looking to sell over 100 billion won this year and Daewoong Pharmaceutical’s entry imminent in Korea, the industry expects that Takeda may not be able to postpone the launch of Vocinty any longer.

 

However, one obstacle for Vocinty, which is sold under the name Takecab in Japan, is its price.

 

In Japan, the 10mg Vocinty tab.

 

is sold at 130.3 yen (1,339 Korean won) and the 20mg Vocinty tab.

 

is sold at 195.5 yen (2,005 Korean won).

 

This is more expensive than the 50mg K-Cab tab that is currently sold at 1,300 won in Korea.

 

On this, an official from B Pharmaceuticals said, “Many considerations need to be made for a product’s release including the adjustment of its price.

 

However, the company may be able to contemplate much longer, considering the increased P-CAB market in Korea.

 

In addition to Vocinty, which verified its competitivity in Japan, the introduction of Daewoong’s Fexuprazan in the market may trigger a three-way race in the P-CAB market."