Should Eliquis' surge make Xarelto fans very, very afraid? Not really, analyst says

Johnson & Johnson ($JNJ) and Bayer are wont to brag about their achievements with Xarelto, one of the new generation of anticoagulant meds. Rightfully so: Though second to that market by many months, the companies grabbed market share from their old standby rival warfarin and their head-to-head competition Pradaxa, too.

Even when the third-to-market Eliquis arrived--armed with some impressive trial data, too--Xarelto kept its share lead. Right now, it has some 60% of the new oral anticoagulant class, say analysts at Sanford C. Bernstein & Co.

Now, though, Eliquis has shifted into a higher gear, with direct-to-consumer ads and beefed-up sales efforts at Pfizer ($PFE) and Bristol-Myers Squibb ($BMY). It sales are growing, with $774 million in 2014, up from $146 million the previous year. Its market share is growing, too.

Do Xarelto fans need to fasten their seatbelts for a bumpy ride?

Not yet, Bernstein's Ronny Gal says.

Yes, Eliquis will likely build up a bigger share of that class. But it's not likely to steal much of Xarelto's thunder. Bayer and J&J have built up a broad base of indications for their med, and they invested a lot of money in large clinical trials, an investment that's likely to continue paying off.

"Both an assumption of the continuation of current trends and our physician survey suggest ongoing growth of Xarelto without loss of a leading market share position," Gal wrote in a recent investor note, adding that he's expecting the drug to keep about 50% of the market in 2020.

And even if it does lose some 10 percentage points, share-wise, by then, that doesn't mean sales won't keep growing. Both Xarelto and Eliquis are focusing on grabbing share from warfarin right now, and it seems to be working--to the point where Gal expects €3.8 billion from the drug by 2020.

A couple of caveats, however. If Pfizer and Bristol-Myers decide to target Xarelto in a share battle, there's a bigger risk of loss for the Bayer and J&J med. Then there's Savaysa, the new entry into the warfarin-alternative market from Daiichi Sankyo. Though it doesn't have much to differentiate it from its rivals, Daiichi could get aggressive with pricing, which would obviously ratchet up the pressure.

Dr. Andrea Natale

Meanwhile, Bayer and J&J continue to build up stats in Xarelto's favor. Over the weekend, the companies announced data from the VENTURE-AF study showing that Xarelto was as safe as warfarin in atrial fibrillation patients undergoing catheter ablation. "Given the dose adjustments often needed for patients on vitamin K antagonists, such as warfarin, to ensure the medicine is working effectively, rivaroxaban may offer a simpler approach in this setting," said the study's lead author, Dr. Andrea Natale, executive medical director at St. David's Medical Center's Texas Cardiac Arrhythmia Institute.

- see the J&J release

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