Troubled psoriasis med brodalumab debuts in Japan with mighty Cosentyx in its sights

Kyowa Hakko Kirin is rolling out the psoriasis med brodalumab this week in Japan, its first world market, but it faces a tough road ahead. The next-gen med will go up against Novartis' first-mover Cosentyx, which has been tearing up sales in the U.S.

The two drugs are part of a new class of interleukin-17 inhibitors aimed at inflammatory diseases. Brodalumab, which will be sold under the brand name Lumicef, was approved in Japan last month as a second-line treatment for psoriasis vulgaris, psoriatic arthritis, pustular psoriasis, and psoriatic erythroderma. 

Lumicef is the third IL-17 inhibitor to make its worldwide debut, after Cosentyx (secukinumab) and Eli Lilly's Taltz (ixekizumab), which both launched in their first markets last year. Lumicef claims second place in Japan, however, because it is launching ahead of Taltz. Lilly delayed its rollout amid a dispute with the Japanese authorities over prescribing restrictions and pricing.

Originally discovered by Amgen and licensed to Kyowa Kirin in Japan in 2011, brodalumab had been trumpeted as a potential blockbuster, before data last year suggested it may cause suicidal thoughts. On that word, Amgen bailed out of the drug, handing full rights to development partner AstraZeneca. That started a game of pass-the-parcel, and AZ has since sold U.S. brodalumab rights to Valeant Pharmaceuticals--along with some other international territories--and European rights to Leo Pharma. 

A unanimous--but guarded--recommendation by an FDA advisory committee in July has only gone some way to alleviate those concerns. Observers expect the drug to require risk-management programs that could hobble its ability to contend with Cosentyx and Taltz.

Kyowa Kirin is rolling out Lumicef with a list price of 73,158 yen (around $728) per 210 mg dose, setting its monthly cost--after an induction phase--at around $1,450. At first glance, that seems a premium to Cosentyx, which costs around $14,300 per year or merely under $1,200 per month.

Analysts at Credit Suisse suggested in May that global sales of brodalumab will reach a little under $600 million by 2020, with just $56 million of that total coming from the Japanese market. 

In comparison, Cosentyx has romped away in the market, adding $436 million to Novartis' coffers in the first half of the year, and Credit Suisse is predicting the drug will reach almost $3.5 billion by 2020, ahead of Taltz, whose sales are expected to hit $1.1 billion in that year.

Related articles:
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AstraZeneca auctions off troubled psoriasis drug to Valeant in $445M deal
AstraZeneca isn't giving up on brodalumab despite its links to suicide
Suicide stunner prompts Amgen to dump brodalumab, denting AstraZeneca's rep