J&J's Invokana continues downward market-share spiral as Lilly, BI's Jardiance advances

J&J's Invokana has lost 6 percentage points of market share since December.

Johnson & Johnson’s Invokana is losing ground to its biggest rival—and fast.

On Tuesday, the New Jersey drugmaker reported that the drug had missed forecasts in the second quarter, coming in about $76 million, or 20.5%, below consensus estimates of $371 million, Barclays analyst Geoff Meacham noted. And that was in a quarter when the overall market expanded by 3.5%, according to J&J’s projections.

The reasons were threefold, Credit Suisse analyst Vamil Divan wrote in a note to clients. Increased contracting discounts and higher utilization in Medicaid took their tolls, but so did loss of market share: For the week ended July 7, Invokana boasted 45%, while Eli Lilly and Boehringer Ingelheim’s rival SGLT2 med Jardiance controlled 23%. And that’s a big slide from the last week of December, when Invokana and Jardiance held 51% and 16%, respectively.

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That trend may not be reversing anytime soon, either, considering the amputation risk that’s popped up to plague the J&J med. In May, U.S. regulators mandated that the pharma giant add warnings to Invokana’s label about an increased risk of leg and foot amputations. And the following month, J&J’s cardiovascular outcomes trial, Canvas, confirmed that the med increased the rate of amputations by about twofold.

“There's still a lot of good news about the Canvas trial when you really look into the data. At the same time, the recent labeling change has also impacted along with just the overall competitive environment,” CEO Alex Gorsky told investors on the second-quarter conference call, adding that “we … recognize the competitive nature of the category.”

Those other Canvas data, though, didn’t stack up to Lilly and BI’s own outcomes results in the death-risk-reduction department. While J&J’s med was able to post a cardiovascular benefit, its 13% death risk pare-down couldn’t touch the 38% performance from Jardiance that in December netted that med a new indication.

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And as of now, Invokana appears to be alone on the amputation-risk front, as its rivals have been quick to point out. Both BI and AstraZeneca, which makes Farxiga, in June unveiled analyses confirming their meds’ safety, leaving J&J with “some questions to answer,” Mike Crichton, AZ’s head of cardiovascular and metabolic diseases, said in an interview at the time.

“I think what you’re going to see is a shifting probably to two SGLT2s as opposed to three,” he predicted.