Two of Roche’s oncology blockbusters are facing dire straits as first-ever biosimilar competitors have entered the U.S. market. Now, a major insurer is putting its money on the new guys.
UnitedHealthcare (UNH) will put Amgen biosimilars of oncology meds Avastin and Herceptin first in line as preferred products in its commercial and community plans starting Oct. 1, giving a major leg up to the newcomers. The two biosims, Mvasi and Kanjinti, launched in the U.S. in mid-July at a 15% discount off the original brands.
That means the colorectal cancer treatment Avastin and HER2-positive breast cancer med Herceptin will no longer be preferred choices for UNH members. The drugs raked in a combined $5.9 billion in U.S. sales in 2018.
UNH’s decision is certainly a blow to Roche, which expected a major sales hit to its longtime blockbusters as biosims flood the market. However, the worst may still be to come for the drugmaker.
Both Avastin and Herceptin, which already face seven approved biosims, may soon face another 11 by 2022, according to Bernstein analyst Ronny Gal. Paired with an additional three to five Rituxan biosims on the way, biosimilar competitors could swallow up 70% of Roche’s oncology market and toll the death knell for its blockbuster trio.
For Amgen, Mylan and Teva, Roche’s loss could be their gain: Gal said the three drugmakers could see potential for revenue of $1 billion, $260 million and $470 million, respectively, for their biosims.
However, outside of Amgen, those competitors will have to wait for those sales. UNH is listing a slate of as-yet-unlaunched biosims—including Pfizer’s Avastin replica Zirabev and Herceptin clones like Celltrion and Teva’s Herzuma, Mylan and Biocon’s Ogivri, Samsung Bioepis’ Ontruzant and Pfizer’s Trazimera—as nonpreferred products.
However, for spectators anticipating a full biosim onslaught, Amgen’s preferred turn could be a one-off—at least for now.
Brand-name drugs like Johnson & Johnson’s immunology blockbuster Remicade and Amgen’s bone marrow stimulant Neulasta retained their preferred status over biosimilar competitors from Celltrion and Pfizer, Samsung Bioepis, and Merck, among others.
The only other biosim that UnitedHealthcare flagged as preferred was a Neupogen copy from Novartis’ Sandoz unit, which now is required for use prior to Amgen’s original biologic, follow-up treatment Granix or Pfizer’s biosim Nivestym.
With Herceptin and Rituxan in danger, Roche is also steeling itself for biosim competitors to its bestselling Rituxan, which hit $4.24 billion in U.S. sales in 2018.
Teva and Celltrion are expected to launch Truxima, their Rituxan biosim, at some point this year. A Rituxan copy from Fosun Pharma’s Shanghai Henlius Biotech was the first-ever biosim approved in China, foreshadowing the legacy megablockbuster’s continued decline overseas. In Europe, where Rituxan biosims have already dropped, sales of the drug plummeted 46% in the fourth quarter of 2018.
Editor's Note: This story has been updated to correct an error. Amgen's Mvasi and Kanjinti will not be listed as preferred products in UnitedHealthcare's Medicare Advantage plans.