BMS, Pfizer's Eliquis gets a NICE boost in rivalry with Pradaxa, Xarelto

Bristol-Myers Squibb ($BMY) and Pfizer ($PFE) got a positive recommendation from the U.K.'s cost gatekeeper for its new-age clot-fighter Eliquis, giving the companies a boost as they chase $3 billion in sales for the drug and compete with rivals Pradaxa and Xarelto.

The National Institute for Health Care and Excellence (NICE) gave a draft OK to the drug in patients with deep vein thrombosis (DVT), which can lead to a potentially fatal blood clot in the lungs called pulmonary embolism (PE). Unlike warfarin, the old standard therapy, Eliquis does not require frequent blood tests to make sure it's working correctly--a selling point it shares with its next-gen competitors.

But Eliquis could have an edge on other new anticoagulants, NICE's Carole Longson said in a statement, because its lower dosing option reduces the risk of bleeding throughout treatment, which increases the odds that patients will stay on the drug long-term.

A nod from the U.K. cost watchdog bodes well for Eliquis, as the drug competes in a three-horse race with Johnson & Johnson ($JNJ) and Bayer's Xarelto and Boehringer Ingelheim's Pradaxa. Eliquis, Pradaxa and Xarelto are all approved in the U.S. to treat blood clots in the legs and lungs and prevent their recurrence.

But Eliquis, the third entrant to the warfarin replacement market, got off to the slowest start. The drug struggled to gain traction after a less-than-impressive launch, with analysts' predictions for 2014 sales falling 60% between late 2012 and late 2013. Xarelto, the second to join the next-gen anticoagulant race, quickly began to poach market share from Pradaxa after it hit the market. Meanwhile, Pradaxa has faced safety issues and struggled to rise to the top after losing its first-to-market advantage.

Still, BMS and Pfizer have not abandoned their quest for the new-age anticoagulant throne. Last year, the companies beefed up U.S. DTC advertising for Eliquis and strengthened its global sales force, spending $8 million on doctor payments to market the drug in 2014.

All the companies' hard work has started to pay off, as BMS and Pfizer reported $774 million in sales from Eliquis in 2014, up from $146 million in 2013. At the JP Morgan Healthcare Conference earlier this year, incoming BMS CEO Dr. Giovanni Caforio reported the drug is the No. 1 agent in the U.S. in new cardiology brand-to-brand prescriptions, a feather in the company's cap as it continues to battle it out with Bayer, J&J and Boehringer.

- read NICE's statement

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