Disease: Hepatitis C
Approved: Aug. 3, 2017
Sales, first four full quarters: $3.01 billion
AbbVie’s pan-genotypic hepatitis C therapy Mavyret came with a clear advantage over Gilead Sciences’ earlier-to-market drugs Vosevi and Epclusa. It’s an 8-week treatment, whereas the others cure the disease in 12 weeks.
To sweeten the deal, AbbVie also priced the drug at a steep discount over its competitors and even the company’s own older drug Viekira. When Mavyret entered in 2017, its list price was $26,400 per course, while both Vosevi and Epclusa cost $74,760 for the full 12-week treatment.
AbbVie clearly knew where its strength lay. In a direct-to-consumer campaign called “Face the Cure,” actors who portray patients repeated the phrase “in only 8 weeks,” emphasizing Mavyret’s short time to cure.
Sales in the early days repeatedly exceeded expectations. For the first quarter of 2018, Mavyret contributed $894 million to AbbVie’s HCV haul of $919 million, which was 60% ahead of consensus. At that time, CEO Richard Gonzalez didn’t expect revenues to slow down, saying the market was “going to be around for a long, long time.”
If Mavyret had continued that kind of rapid growth, it could have helped AbbVie diversify its offerings beyond its megabrand immunology med, Humira, in a big way. Thing is, it didn’t. Mavyret caught the last train to HCV growth land. Indeed, the overall HCV market peaked in 2015 with worldwide sales of about $23 billion, and it’s been trending downward since.
As existing patients were quickly cured and effectively left the market, AbbVie soon started to see declines, too. In Q2 2018, Mavyret generated sales of $932 million; in Q3, the number dropped to $839 million and in Q4 fell further, to $819 million.
Then Express Scripts kicked Mavyret off its national preferred formulary for 2019. To heap more pressure on AbbVie, Gilead in 2019 officially launched authorized generics to Epclusa and Harvoni at a list price of $24,000 for the full course of therapy. IQVIA scripts data previously showed the generics helped Gilead steal back some market share it had lost to Mavyret and other rivals.
For 2019, Mavyret global sales reached $2.89 billion, down 16% year over year, and that was only its second full year on the market. To be fair, almost $3 billion isn't a figure to scoff at. But it was no match to Solvadi’s enormous first-year launch record of $10.28 billion in 2014 following its December 2013 nod.
Mavyret could have had another chance at a sales boost when it secured a go-ahead last May in China, where an estimated 10 million HCV patients live. However, Gilead preempted AbbVie by winning national reimbursement for Epclusa and Harvoni. The listing will last for two years beginning in 2020, shutting out all other comers till 2022.