Sales of immunotherapy for Cancer are ↑18 times in 4 years

Sales of 5 types of immune checkpoint inhibitors: ₩126.7 billion

Keytruda sales in the first half of 72.3 billion won,57% share

(Clockwise from top left) Yervoy, Opdivo, Keytruda,Imfinzi,& Tecentriq

Immunotherapy for Cancer is expanding rapidly in the domestic pharmaceutical market.

 

The domestic immune checkpoint inhibitor market started with Yervoy (Ipilimumab), Keytruda (Pembrolizumab), and Opdivo (Nivolumab), and generics such as Tecentriq (Atezolizumab) and Imfinzi (Durvalumab) were added one after another, sales increased by 18 times over the past four years.

 

MSD's Keytruda, which took the lead in the lung cancer treatments, occupied 60% of the total market, showing its influence, and Roche's Ticentric' & AstraZeneca’s Imfinzi are on the rise.

 

According to IQVIA, a drug market research institute on the 1st, sales of five types of Immunotherapy for Cancer in the first half of this year was a joint venture of ₩126.7 billion.

 

This is a 31.7% increase from ₩96.1 billion in the first half of last year.

 

It increased by 17.5 times from ₩7.2 billion four years ago.

 

Immuno-anticancer agents are monoclonal antibodies that induce T cell activation by blocking inhibitory signals from T cells involved in immune regulation in the body.

 

Unlike chemotherapy or targeted anticancer drugs, they are also called third-generation anticancer drugs in that they treat cancer by activating the body's immune system.

 

There are various types of immune anticancer agents, but immune checkpoint inhibitors that treat cancer by activating immune function by suppressing the immune checkpoint, which is a pathway through which cancer cells evade immune cells, are collectively referred to as immune anticancer drugs.

 

In Korea, BMS and Ono Pharmaceutical's immune anti-cancer drug Yervoy was approved in December 2014 as the primary treatment for melanoma patients who could not operate or have metastasized, Yervoy is the first immune checkpoint inhibitor that acts on the CTLA-4 protein on the surface of immune cells.

 

In 2015, immune checkpoint inhibitors with mechanisms that inhibit PD-1 protein, such as Keytruda of MSD and Opdivo of BMS, were released and the market scale was in earnest.

 

Since then, competition is accelerating with the launch of Roche's Tecentriq in 2017, AstraZeneca's Imfinzi in 2018, and Merck·Pfizer's Bavencio in 2019.

 

Quarterly sales trend of five major immune checkpoint inhibitors (Unit: ₩ million, Source: IQVIA)

Currently, Keytruda has taken the lead in the market.

 

The sales of Keytruda in the first half of this year were totaled at ₩72.3 billion.

 

It is 26.4% higher than ₩57.2 billion in the first half of last year, leading overall drug sales.

 

Of the five immune checkpoint inhibitors, the proportion of Keytruda accounted for close to 57.1%.

 

Keytruda inhibits the 'PD-1' protein on the surface of T cells to prevent binding to the PD-L1 receptor and acts as a mechanism to activate T cells.

 

Following the first indication, melanoma, it has shown excellent efficacy in over 30 carcinomas such as lung cancer, head and neck cancer, gastric cancer, and cervical cancer, showing overwhelming results worldwide.

 

Last year, it surpassed ₩10 trillion in global sales, ranking second in sales following Humira (Adalimumab), and It is observed that it will rise to the top in global sales by 2026.

 

In Korea, because of its high price, the quarterly sales of Keytruda remained around ₩3 billion, but the application of health insurance benefits for secondary treatments for non-small cell lung cancer in August 2017 acted as a catalyst for sales growth.

 

Keytruda sales exceeded ₩10 billion in the first quarter of 2018, and quarterly sales of ₩30 billion have been recorded since the second quarter of last year.

 

In the first quarter of this year, it lowered Lipitor (Atorvastatin) and rose to the top in domestic pharmaceutical sales, and continued to lead for two consecutive quarters.

 

If the reimbursement is expanded, the sales volume is expected to increase even more.

 

However, there is a difference between the sales aggregate of Keytruda and the sales that the company actually secures according to the risk-sharing contract (RSA) of the refund type·expenditure cap signed with the government at the time of listing.

 

Opdivo, which was once pointed as the biggest rival of Keytruda, widened the gap with sales of ₩30.6 billion in the first half of this year.

 

Opdivo lost its leadership to Keytruda after clinical failure related to primary lung cancer treatment in 2017.

 

In Korea, after setting a new record for quarterly sales of ₩17.2 billion in the fourth quarter of 2018, the trend continues to decline.

 

As of the first half of this year, the share of the five immune checkpoint inhibitors accounted for 24.2% of sales.

 

Opdivo is evaluated as having missed the market leadership because it failed to preoccupy it as a primary treatment indication for non-squamous non-small cell lung cancer showing positive PD-L1 findings.

 

Non-small cell lung cancer accounts for about 80% of all lung cancers.

 

About 25-30% of them are classified as squamous non-small cell lung cancer.

 

Market share of 5 immune checkpoint inhibitors in the first half of 2020 (Unit: %, Source: IQVIA)

Except for Keytruda and Opdivo, the influence of other items in the immune checkpoint inhibitor market is still insignificant.

 

In the first half of this year, Yervoy's sales were ₩700 million, similar to the same period last year.

 

Yervoy was first released in Korea, but it has not exceeded ₩2 billion in annual sales.

 

Although it is trying to rebound in sales by adding indications for combination with other treatments such as Opdivo, its application range is limited compared to other PD-1 and PD-L1 inhibitors.

 

The quarterly sales of Roche's Tecentriq and AstraZeneca's Imfinzi are rapidly increasing since their domestic release.

 

Tecentriq recorded ₩15 billion in sales in the first half of last year, more than four times higher than ₩3.7 billion in the first half of last year, making it the third largest of the five immune checkpoint inhibitors.

 

The market share rose to 11.8%.

 

Imfinzi, which started generating sales in the first half of last year, recorded sales of ₩8.1 billion in the first half of this year.

 

Five kinds of immune checkpoint inhibitors are trying to expand their indications based on continuous clinical research.

 

Bavencio recently concluded a drug price negotiation with the NHIS, and the application of insurance benefits is imminent.

 

For the time being, the domestic immune checkpoint inhibitor market is expected to continue high growth.