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Opdivo biggest earning PBS cancer brand

Posted 18 January 2018

BMS' checkpoint inhibitor Opdivo is on track to be the highest earning PBS cancer brand of 2017/18 as its pre-rebate income growth outstripped competitors in the final quarter of 2017.

PBS-listed in May 2016, Opdivo was in line to finish 2017 just outside the top five PBS cancer brands with annual pre-rebate income of $83 million.

However, as the highest earning cancer brand on the PBS for every month since September 2017, its income for the 2017/18 financial year will no doubt overtake the current leading cancer brand in terms of PBS pre-rebate income, Herceptin.

Herceptin and its subcutaneous form Herceptin SC were in line to earn $168 million pre-rebate in 2017, making the Roche drug the biggest cancer earner on the PBS for 2017.

Opdivo's checkpoint inhibitor rival Keytruda will be the second highest earning drug on the PBS for 2017 with expected pre-rebate earnings of $135 million followed by Mabthera/Mabthera SC on $132 million.

Celgene's blood cancer drug Revlimid will finish the year in fourth position with anticipated earnings of $108 million while Avastin will round out the top five cancer drugs with anticipated earnings of $85 million.

While Opdivo will most likely just miss out on a place in the top five, with monthly pre-rebate earnings expected to hit $20 million in December the checkpoint inhibitor's pre-rebate income for 2017/18 should be around $200 million.

A US report has tipped Opdivo to be the second highest earning drug globally in 2022, with three of the top six cancer drugs of the future coming from the highly touted PD-1/PD-L1 or checkpoint inhibitor class.

Opdivo rival, MSD's checkpoint inhibitor Keytruda, was tipped to fall in as the fourth biggest selling cancer drug globally in 2022, with a third PD-L1 drug, Roche's Tecentriq, coming in sixth.

Based on a report by Evaluate Pharma, Revlimid is tipped to be the biggest selling drug in the world in five years with Janssen's lymphoma drug Imbruvica and Pfizer's breast cancer drug Ibrance completing the international future top six.

PBS listed in December, Imbruvica is also sure to finish 2018 among the highest earning cancer drugs on the PBS in pre-rebate income. Conversely Ibrance, which has to date failed to get a positive recommendation for PBS listing despite two appearances before the PBAC in 2017, has little hope of a PBS berth before 2019.

The first checkpoint inhibitor to be listed on the PBS, Keytruda will be keen to snatch back the lead it lost to Opdivo in September, and has a shot having been positively recommended by the PBAC in classical Hodgkin lymphoma in August while a decision on first-line lung cancer was deferred in November as the PBAC seeks a better pricing deal.

A positive recommendation and subsequent listing in first-line lung cancer would strongly boost Keytruda's PBS pre-rebate income for 2018, although MSD is likely to have to make significant rebate concessions to gain the recommendation.

MSD has also signalled its intention to chase PBS reimbursement for Keytruda in combination with chemotherapy in lung cancer, with new data out this week increasing its chances of success. The data is also likely to cement Keytruda's global lead over its PD-1/PD-L1 rivals in the lucrative lung cancer area.

Recommended by the PBAC for lung cancer in November, Tecentriq will also make its mark on the PBS in oncology this year.

*Estimated 2017 PBS income (pre-rebate)

Megan Brodie

* Analytics and assumptions for this story are based on PBS-date-of-processing data as supplied by the Department of Human Services and generated using MiPortal, Mercurial's cloud-based business intelligence and analytics platform. Click here for a free trial or contact Regan McCracken on 02 8459 5244.