COVID-19 affected off-patent drug market share plunge?

Lipitor, Crestor, Plavix, Aricept and Exforge simultaneously experience drop in Q1 market share

Continued to grow last year, regardless of generics expanding

Prescription tendency could have changed due to COVID-19 pandemic

Although off-patent originals have been consistently expanded their market shares in recent years unaffected by the army of generics entering the market, the original’s market share shrunk in last first quarter.

 

The Korean pharmaceutical industry experts analyze the originals struggled to grow in the market against intense marketing of generics amid COVID-19 pandemic.

 

◆Lipitor and Crestor market shares stagger in the first quarter On May 10, pharmaceutical industry research firm UBIST stated Pfizer’s antihypertensive Lipitor (atorvastatin) has generated 47 billion won from outpatient prescription in the first quarter showing 0.2 percent decrease from the same time last year.

 

Its prescription volume has been surging for last few years, but the growth seems to have slowed down.

 

Compared to the first quarter last year, the prescription volume has increased only by 5.5 percent.

 

The overall prescription volume of individual atorvastatin drugs in the first quarter reached 138.2 billion won with 2.3 percent increase from the year before.

 

The overall market volume has grown but the original’s prescription volume has gone down.

 

Quarterly prescription volume (left) and market volume (right) of Lipitor (Unit: KRW 100 million) Source: UBIST

In the individual atorvasatin drug market, Lipitor’s pie took up 33.98 percent, which was reduced by 1 percent point compared to last year (34.83 percent).

 

Even compared to the fourth quarter (34.92 percent) last year, the first quarter’s volume fell by 1 percent point.

 

Since the third quarter of 2016 (33.66 percent), Lipitor’s quarterly market share has hit the lowest point in 42 months.

 

Regardless of over 100 generics entering the market from 2009 as Lipitor’s patent was expired, the original has been constantly growing in the market.

 

Lipitor’s market share steeply expanded from 31.70 percent in the first quarter 2015 to 34.92 percent in the fourth quarter last year.

 

Although it maintained the market share over 34 percent since the fourth quarter of 2016, the figure plummeted this year at around 33 percent.

 

Besides Lipitor, many of off-patent drugs that showed off their strong growth until last year saw their market share drop, simultaneously.

 

Quarterly prescription volume (left) and market volume (right) of Crestor (Unit: KRW 100 million) Source: UBIST

In the first quarter, Crestor (rosuvastatin) has made 22.5 billion won, recording a 5.1-percent drop from the same time last year (23.7 billion won).

 

Compared to the previous year, Crestor had an 11.8-percent growth in last year’s first quarter, generating 23.7 billion won.

 

The overall individual rosuvastatin drug market in the past first quarter has generated 84.1 billion won, jumping 5.2 percent from the same time last year.

 

Despite the general growth in the market, Crestor’s first quarter market share has gone down significantly from 29.67 percent last year to 26.76 percent this year.

 

Even against the last fourth quarter, this year’s first quarter market share fell by 2 percent point from 28.63 percent.

 

Although it defended the market share of around 30 percent against over 100 generics for a while, this year’s first quarter market share has hit the lowest point.

 

◆Prescription volumes in Plavix, Aricept and Exforge also plunge The anticoagulant agent clopidogrel’s market also demonstrated similar trend.

 

The first quarter prescription volume in Plavix (clopidogrel) was at 23.0 billion won with 1.4 percent increase than the previous year.

 

The growing tendency continued but it was sluggish.

 

In last year’s first quarter, Plavix generated 22.7 billion won, increased by 10.7 percent from the year before.

 

In the first quarter of 2018, the drug’s prescription volume was 6.8 percent higher than the previous year.

 

The overall individual clopidogrel drug market generated 2.6 percent more in the first quarter this year at 89.8 billion won, compared to 87.6 billion won in 2019.

 

In the first quarter clopidogrel market, Plavix’ share was brought down to 25.65 percent by 0.38 percent point from 25.93 percent in last year.

 

Compared to the fourth quarter last year at 26.27 percent, this year’s first quarter share was decreased by 0.62 percent point.

 

The drug’s quarterly market share recorded the lowest in 18 months since the third quarter of 2018.

 

Quarterly prescription volume (left) and market volume (right) of Plavix (Unit: KRW 100 million) Source: UBIST

Moreover, other major off-patent drug market manifested noticeable plunge in original’s market share.

 

The overall market of an Alzheimer’s disease-associated symptom treating agent donepezil has made 58.2 billion won this past first quarter with 1.0 percent increase from the same time the year before.

 

Compared to 21.6 billion won made last year, the original brand drug Aricept has only made 23.0 billion won in last first quarter, recording 6.0 percent fall.

 

In 2017 and 2018, Aricept’s first quarter prescription volume marked 18.9 billion won and 20.9 billion won, respectively, and showed a continuous growth but it turned downward this year.

 

Aricept’s market share in the first quarter within the donepezil market has hit the lowest at 37.21 percent.

 

Compared to last year at 39.99 percent, the first quarter share this year fell by 3 percent point.

 

And from the fourth quarter last year, the number was again dropped by 0.3 percent point.

 

Quarterly prescription volume (left) and market volume (right) of Aricept (Unit: KRW 100 million) Source: UBIST

An amlodipine and valsartan combined antihypertensive, Exforge has also slipped.

 

The first quarter prescription volume was at 20.2 billion won marking 1.6 percent drop from the year before.

 

In the first quarter of last year, Exforge has generated 22.0 percent more in prescription volume against the year before.

 

Influenced by the impurity found in valsartan in July 2018, the prescription volume of Exforge has surged but it has been stagnating recently.

 

Taking up 41.54 percent of the combination drug market in this year’s first quarter, Exforge’s share has plummeted by over 3 percent point from 44.91 percent last year.

 

Quarterly prescription volume (left) and market volume (right) of Exforge (Unit: KRW 100 million) Source: UBIST

◆Despite showing continued growth until last year, off-patent drugs crippled this year, possibly affected by COVID-19 In fact, patent-expired novel drugs continued to show strong growth up until last year, regardless of the generics intensely tackling the market.

 

The industry experts claim the originals have advantages in market share growth due to Korea’s unique drug pricing system.

 

When a generic is first released to the market, the original’s reimbursed price is reduced down to 70 percent of its initial pricing.

 

And after a year from then, the pricing is again adjusted to 53.55 percent of the pricing before the patent expiration.

 

The maximum pricing of a generic can be up to 59 percent of the original’s price before the patent expiration, and a year later the price also drops to 53.55 percent of the original’s pre-patent expiration price.

 

The experts argue the prescribers seemingly prefer originals as it gets priced on par with generic pricing before the patent expiration.

 

In this year, however, generics’ market share has gone up significantly.

 

In this first quarter, the overall generic outpatient prescription volume has reached 3.70 trillion won with a 2.7-percent surge from last year at 3.60 trillion won.

 

The industry experts analyze most of the original market has been engulfed by generics.

 

Trend in monthly outpatient prescription volume (Unit: KRW 100 million) Source: UBIST

Some experts carefully question if the COVID-19 pandemic has affected the dull growth of overall off-patent drugs.

 

When multinational pharmaceutical companies have halted their salespeople from visiting healthcare institute amid COVID-19 outbreak, Korean companies could have assertively approached the healthcare providers and convinced them to prescribe generics.

 

Since the first confirmed case of COVID-19 in Korea on Jan.

 

20, a growing number of pharmaceutical companies have refrained from visiting healthcare institutes, starting from the multinational companies.

 

Most of the pharmaceutical company salespeople have started working from home as the number of confirmed cases skyrocketed since the discovery of the 31st confirmed case on Feb.

 

19.

 

The experts also speculate many of chronic disease patients could have received prescription for a longer period of time at once to avoid visiting their healthcare providers.

 

They also noted more clear trend in prescription drug market would be visible after April or May, when the pandemic heavily influenced the prescription volume.