The breast cancer medication Ibrance has been the shooting star in Pfizer’s universe, and it’s expected to burn brightly enough to raise the entire company’s fortunes.
That’s despite Ibrance’s competition from newcomer Kisqali, a Novartis drug, and the forthcoming Lilly med abemaciclib. Or so says Morgan Stanley analyst David Risinger, who put out a research note this week saying the Pfizer med has advantages over its new competitors, even beyond its first-to-market status.
“Ibrance is Pfizer's No. 1 growth driver,” Risinger wrote in an investor note. “Now that the competing CDK4/6 profiles are clear, we expect Ibrance to maintain its first-to-market advantage.”
That’s partly because of safety checks and known side effects. Novartis' Kisqali launch has been slow so far, because of requirements that doctors monitor cardiac and liver function, Risinger wrote in an investor note. And new data from Eli Lilly showing abemaciclib’s elevated diarrhea risk won’t help that drug either, he said.
Side effects are an issue for all three drugs; Kisqali and Ibrance each carry warnings of neutropenia, requiring regular blood counts. Kisquali is also tagged with a heart rhythm risk and liver toxicity, though, and patients are advised to undergo testing for both ahead of treatment and during it, too. Abemaciclib has been associated with severe diarrhea—which Lilly says is treatable, and subsides as treatment continues—and Risinger expects the med’s final label to flag a risk of blood clots. (Ibrance had one initially, but it was removed in March.)
And then there are Ibrance’s other market prospects. Expectations of sales overseas should be higher, the analyst figures, given the history of breast cancer therapies and their success outside the U.S. Plus, results of a phase 3 Ibrance trial in patients undergoing surgery are due in 2020, and if that succeeds, Risinger figures the Pfizer drug can rule that category of treatment—and it’s an $8 billion market.
“Most importantly, we believe Ibrance’s clean profile positions it to garner the most share in adjuvant breast cancer,” he wrote.
Pfizer executives were feeling upbeat about Ibrance in the wake of Kisqali’s launch earlier this year. While it’s “a little bit early to comment” on the rollout, “so far we have seen a minimal uptake of this product,” Pfizer’s Innovative Health President Albert Bourla told investors in early August.
Ibrance is certainly expected to pump up Pfizer’s top line for the rest of this year and beyond, particularly if it hits Morgan Stanley’s optimistic benchmarks. The firm sees $939 million in sales for the third quarter and a touch over $1 billion in the fourth, leading to $3.5 billion for the full year. Next year? $4.85 billion, a full 15% above consensus estimates. Pfizer will be pleased if those predictions come true.
But another Pfizer observation could bode well for all three meds in the class. The CDK 4/6 share in breast cancer is growing overall as Novartis rolls out its med, Bourla said, expanding to about 57% from 50% by the end of Q2. That's an sign “the Kisqali introduction could potentially grow the total market.”
“As you know, only 50% of the patients that could receive benefits from CDK treatments are now under a CDK program,” he reminded investors. So there could be room for all three to make a splash—even if Pfizer's ends up bigger than the rest.