GlaxoSmithKline just inherited its biggest threat to Nucala in the form of a new AstraZeneca rival. But the British drugmaker says it’s down for some marketplace battling.
AstraZeneca's Fasenra snagged an FDA approval last week for the treatment of severe eosinophilic asthma, and analysts have pegged its less frequent dosing as a potential advantage. But for Glaxo’s part, it’s “ready to fiercely compete,” said Cheryl MacDiarmid, GSK’s SVP of primary care.
“It’s a challenge having someone new come to the market, but it’s also an exciting moment because it makes sure that we’re on our 'A' game,” she added.
And as she figures, Nucala has its own advantages that’ll help it maintain the lead it's built up over two years on the market. For one, the med has data on its side showing it can cut down on exacerbations, and it’s “really consistent” data that “still stands apart,” she said.
Some analysts aren't sure. Fasenra, for its part, has posted data showing it could cut exacerbations by up to 51% and improve lung function and asthma symptoms in severe eosinophilic asthma patients, and Bernstein's Ronny Gal at the time called those results "similar" to those from its rivals.
Regardless, MacDiarmid sees plenty of room for both meds in the market. “This is a really untapped patient population,” she said, with about 300,000 patients who could benefit from a biologic therapy; right now, just 15,000 to 20,000 are taking Nucala.
To help dive deeper into that pool—and support its growing respiratory portfolio—GSK has upsized its medical organization, doubling the size over the last two years. That organization fields questions coming in from healthcare professionals, and as MacDiarmid noted, pulmonologists have had their fair share.
Unlike for allergists, who have spent years prescribing Novartis’ less-targeted severe asthma therapy Xolair, for pulmonologists, working with biologics—and giving injections in their offices—is new.
“That’s taken some of them a bit of time to sort that out—practically, ‘how do I do that in my practice?” she said. Glaxo has been “quite active making sure that we’re amplifying our medical support in response to their needs.”
The company intends to keep increasing its spend behind the med as it grows its patient tally, and some of that spend will go toward reaching patients themselves. While the company hasn’t done any DTC television advertising for Nucala, it’s been “doing some work in the consumer space” through “different multichannel resources” to reach both patients who aren’t yet on therapy and also those who are and may need help “getting comfortable with the journey they’re already on,” MacDiarmid said.
As it prepares to face another year of payer pressure in the respiratory space, Glaxo will need all the Nucala contributions it can get. The company is counting on its portfolio to buoy its pharma unit going forward, but the negative trends aren’t going anywhere, MacDiarmid said, adding that “continued margin pressure in the U.S.” is “just the environment we live in.”
“Nothing new, no surprises,” she said. “It will continue, full stop.”