AstraZeneca goes to battle with GSK with nod for Nucala challenger Fasenra

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AZ's Fasenra is dosed every eight weeks after the first three doses, a less frequent schedule than Nucala or Cinqair's.

AstraZeneca is about to find out whether its third-to-market respiratory biologic can stand out from the crowd—and a lower price might just do it. Fasenra, known in the clinic as benralizumab, won FDA approval for a severe type of asthma, and AZ is undercutting its two chief rivals.

Tuesday's nod covers Fasenra as an add-on treatment for severe eosinophilic asthma in patients 12 years and older. And now, it’ll take aim at three big names in the respiratory business: GlaxoSmithKline and its first-in-class Nucala, Cinqair from Teva and Xolair from Novartis, an anti-IgE drug that doesn't have a specific approval for eosinophilic asthma but still contends with the trio in severe asthma.

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AstraZeneca isn’t taking the task lightly. To take on the more established group, it’s socking major money into the launch. The rollout will be “very, very competitive” in terms of “field force size, marketing dollars, educational dollars,” company respiratory VP Tosh Butt said last month.

Fasenra does have some features that set it apart; for one, it’s dosed infrequently, with patients receiving the med every four weeks for the first three doses and every eight weeks after that. Nucala and Cinqair, meanwhile, are administered monthly, while patients may need Xolair as frequently as twice per month.

And then there's the price. For the first year of treatment, the annual price will be $38,000, which is "in line with the treatment cost of other biologics in severe asthma," and AstraZeneca spokesperson said via email. After that, the price is lower: In a maintenance year the annual price will be $28,000 or $33,000 for 6 or 7 doses. And that's "below the treatment cost of all other biologics in severe asthma." All these numbers are list prices, before rebates and discounts given to payers.

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Fasenra is also on the more convenient side when it comes to delivery. Like Nucala, it’s a subcutaneous product, making it easier to take than intravenous Cinqair.

Glaxo has a sizable market lead in the space after winning its Nucala asthma approval more than two years ago. The British drugmaker last week filed for a nod in chronic obstructive pulmonary disease (COPD), and it’s testing the drug in other areas—including nasal polyps—too.

But if AstraZeneca can generate the blockbuster Fasenra sales that some analysts expect, they’ll be welcome on its top line. The company is still working toward a turnaround, and with questions swirling around its approach in the all-important immuno-oncology space, contributions from areas such as respiratory and diabetes are critical.