ESC 2021: Bayer and Merck's Verquvo stakes its claim as a complementary heart failure treatment

Merck & Co.
Merck has precious few new drugs with potential for big sales. But with Verquvo, the company, along with partner Bayer, believe that there is significant potential in treating worsening heart failure patients. (Merck & Co.)

Analysts don’t see much potential for Bayer and Merck & Co.’s acute heart failure drug Verquvo. In a market dominated by Novartis’ Entresto and with AstraZeneca’s formidable Farxiga as a looming threat, Verquvo has an uphill climb.

But Bayer’s global head of cardio renal and heart disease, Lars Schwichtenberg, sees a pathway to success in more ways than one.

“Verquvo is a stimulator of a pathway that is deficient in these patients,” Schwichtenberg said in an interview with Fierce Pharma. “It’s restoring this pathway that’s unaddressed by current therapy. And therefore we also have this situation where it is complementary to what other drugs are addressing to help these patients.”   

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In considering Verquvo’s potential, “complementary” is a mantra. And some data presented Saturday at the European Society Cardiology Congress could help prove their case.

The Victoria study showed that when provided along with standard of care Entresto, Verquvo reduced the risk of death and hospitalization by 4.2%.      

Worsening (or acute) heart failure occurs in patients with reduced ejection infraction who require IV therapy. Of these, 56% will be hospitalized again within 30 days and within the next two years, one in five will die.

“These patients are in a downward spiral,” Schwichtenberg said. “This is really a severely sick patient population and these numbers illustrate that additional therapy is much needed.”

Identifying the urgency to treat these patients, the ESC has recognized worsening heart failure for the first time. In addition, Verquvo has been recommended by the organization on top of foundational heart failure therapies in this patient population who are at tisk of escalating symptoms.

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Verquvo works in conjunction with existing approaches but by way of a different mechanism. While current treatments block the effects of natural neurohormonal systems that are activated in heart failure patients as a result of myocardial and vascular dysfunction, Verquvo works by stimulating soluble guanylate cyclase (sGC), which restores a deficient pathway that's a key factor in heart failure progression.

“This drug is deliberately developed for helping people with worsening heart failure,” Schwichtenberg said. “Other drugs are broader in the heart failure sense, but we have a clear focus.”

Despite this, upon Verquvo’s approval in January of this year, SVB Leerink’s Daina Graybosch projected the sales potential for Verquvo at only $50 million in the U.S. in 2022 and 2023, with potential worldwide sales topping out at $300 million.