Pfizer, BMS' Eliquis takes J&J's next-gen anticoagulant market-share crown

There’s a new novel oral anticoagulant (NOAC) king in town, and that’s Pfizer and Bristol-Myers Squibb’s Eliquis.

The third-to-market clot fighter has unseated Johnson & Johnson’s Xarelto as the leader in its class based on total prescriptions, Bristol-Myers executives said on last week’s earnings call, and the company is not expecting to look back.

A sequential 8% increase in total prescriptions and lower gaps in Medicare coverage compared with the fourth quarter drove a $1.1 billion sales performance for the med, marking the first time it had generated more than $1 billion in a single quarter.

And “we continue to feel good about growth based on leading indicators that we look at in the market,” which are new-to-brand prescription trends and cardiology trends, Murdo Gordon, Bristol’s chief commercial officer, told investors on the call.

Before Eliquis launched, analysts expected big things from Pfizer and BMS’ shared med, with clinical trials hinting the med might be safer than its peers. But a glacial start saw them revise their expectations downward, while Xarelto took the extra time to build its lead.

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After an investment push from both companies, though, the product began showing signs of life in 2014’s Q2, and it has continued steamrolling from there.

That’s not to say Xarelto’s in the rearview mirror for good, though. Plenty of patients are still taking old-guard therapy warfarin, meaning they’re up for grabs when it comes to conversion to a NOAC. “Over half of the total prescription business is still a warfarin-based treatment patient population,” Gordon said, noting that outside the U.S., “the NOAC class is even more underpenetrated in the market.”

Plus, the J&J drug has the class lead in indications, and it’s gunning to add more to the list. As one analyst reminded Bristol’s team on the conference call, Xarelto recently posted positive results in a mammoth trial of coronary and peripheral artery disease patients. The results were so positive, in fact, that the study stopped more than a year ahead of schedule.

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

While those data aren’t yet available to the public, Bristol doesn’t see the performance hurting its atrial fibrillation and veinous thromboembolism share, Gordon said. Plenty of questions are still out there, including the “utility of a NOAC versus antiplatelet drugs in the patient population that was studied,” he pointed out.

“I probably have some more questions related to that trial than I have answers, but we do not see it impacting our AF and VTE business going forward,” he said.