J&J clot fighter battles Pfizer/Bristol for warfarin switches in red-hot market share race

The market-share gap between next-gen anticoagulants Xarelto and Eliquis has never been smaller--and with a high percentage of patients still turning to old-guard therapy warfarin, it’s anyone’s race.

In its Q3 earnings presentation, Johnson & Johnson rolled out a graph of total prescription share that showed Bristol-Myers Squibb and Pfizer's Eliquis steadily gaining on its own market leader, Xarelto.

The way J&J sees it, there’s still a lot of room out there to grow its blockbuster, because about 54% of patients are still using the older, less-convenient med warfarin, J&J said during its presentation. There's reason for that, J&J acknowledged; unlike warfarin, whose blood-thinning effect is easily countered with vitamin K therapy, the crop of new-age meds--save Boehringer Ingelheim’s third-place Pradaxa--has no reversal agent to stop severe bleeding in an emergency.

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But the next-gen drugs have other advantages, and Pfizer and Bristol know those warfarin patients are there for the taking--and the partners aren’t planning to let J&J run away with all the conversions. After getting off to a brutally slow start, Eliquis has picked up the pace on the back of increased marketing spend, and earlier this year BMS claimed it had a future market leader on its hands.

Johnson & Johnson doesn’t sound worried about its rival’s steady rise, though. Its own market share ticked up to 17.5% in Q3, a 1.7-point increase over the same period last year. And the pharma giant still boasts the largest clinical trial program of the group; it’s conducting 10 trials with new indications or label expansions in mind, spanning conditions including heart failure, embolic stroke and coronary artery disease.

Those new line extensions are no small deal, J&J’s worldwide pharmaceuticals chairman, Joaquin Duato, told investors on the company’s Q3 conference call. The extensions for Xarelto--combined with those planned for Type 2 diabetes med Invokana--“have the potential to drive $3 billion to $5 billion in incremental sales for the cardiovascular franchise,” he said.

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