With longtime immunology blockbuster Humira on the decline, AbbVie is looking to next-gen competitor Skyrizi to chip in. A nod from England's cost watchdog could help.
The National Institute for Health and Care Excellence (NICE) recommended (PDF) Skyrizi as a second-line treatment for severe plaque psoriasis in adults who've failed on conventional treatments such as ciclosporin, methoxotrate and phototherapy.
In its final appraisal, NICE said second-line Skyrizi was more effective for plaque psoriasis than Humira and Johnson & Johnson’s Il-12/23 med Stelara and similar in health benefits to J&J’s Tremfya, a head-to-head IL-23 competitor.
AbbVie has touted Skyrizi as a cost-effective alternative to its closest immunology rivals. That growing field includes the aging anti-TNF class, IL-23 and IL-12/23 inhibitors, and next-gen IL-17 inhibitors like Novartis’ Cosentyx, Eli Lilly’s Taltz and Bausch Health’s Siliq.
That cost edge is one reason Skyrizi rolled out a pricing plan in April to include an $88,500 first-year price on the new med—inclusive of two starter doses—and $59,000 maintenance doses.
Alongside a price tag that AbbVie said beats out any other biologic for moderate to severe plaque psoriasis, Skyrizi also benefits from a less onerous dosing regimen with maintenance doses delivered every 12 weeks rather than the industry standard four weeks. Those factors taken together could lead to $3 billion in peak sales, according to SVB Leerink analyst Geoffrey Porges, though AbbVie has offered a $5 billion peak forecast of its own.
Skyrizi has not only proven more cost-effective than some of its competitors but has also beaten them in clinical trials. In June, AbbVie released two-year treatment data for Skyrizi showing 72% of patients saw a 100% improvement in skin clearance over placebo. Skyrizi also worked in relapsed patients, with 84% again achieving clear skin after 16 weeks of treatment.
With such a strong showing from its newest immunology entry, AbbVie has high hopes that the newer drug can absorb many of the patients—and sales—expected to be lost as Humira and its nearly $20 billion in 2018 revenue falls from that lofty peak.
Soon after Skyrizi’s launch in April, AbbVie reportedly began offering 5% to 10% discounts on Humira in an attempt to secure formulary positioning for Skyrizi. Bernstein analyst Ronny Gal said the push for positioning could upset the apple cart with other immunology players and trigger a “pricing war” with payers.
Gal said further discounts on Humira could be in the works if the drugmaker’s JAK-1 inhibitor candidate upadacitinib is approved by the FDA. AbbVie has already rolled out massive Humira discounts as high as 89% in Europe after the drug lost its patent protection late last year.