6. Skyrizi

AbbVie’s Skyrizi isn’t the first IL-23 inhibitor to reach the market, but analysts believe it has "best-in-category" efficacy. (AbbVie)

6. Skyrizi
Company: AbbVie and Boehringer Ingelheim
Disease: plaque psoriasis and more
Approved: March 26, 2019 (Japan), April 23, 2019 (U.S.)
First 11 months of sales: $655 million

AbbVie’s Skyrizi isn’t the first IL-23 inhibitor to reach the market. Johnson & Johnson’s Tremfya (featured later in this report) and dual IL-12/23 med Stelara, plus Sun Pharma’s Ilumya, came before it. And there’s a long list of psoriasis drugs outside of the class, including TNF blockers led by AbbVie’s own megablockbuster Humira and other anti-interleukin therapies such as Novartis’ IL-17A inhibitor Cosentyx.

But AbbVie believes Skyrizi can carve out a meaningful share to fill some of the gap left by Humira when it loses U.S. exclusivity.

Both Skyrizi and Tremfya are offered in prefilled syringes that patients can self-administer, but Skyrizi boasts a convenience advantage of less frequent dosing—the drug’s injected every 12 weeks after two initiation doses a month apart, while Tremfya is administered every eight weeks following the two starter doses.

Skyrizi’s clinical data look convincing, too. In phase 3 studies, about 80% of patients on Skyrizi achieved 90% of clear skin at one year, and around 60% enjoyed completely clear skin. Those efficacy data, as SVB Leerink analyst Geoffrey Porges described as “best-in-category,” were better than what Tremfya and Ilumya saw in their own studies, even though they’re not meant for direct comparison.

AbbVie didn’t just stop there. Months after the U.S. nod, the Illinois pharma rolled out data showing after two years, 72% of Skyrizi patients still saw complete skin clearance. Then in a head-to-head study, Skyrizi topped Cosentyx at clearing patients’ skin at the one-year mark. While 87% of patients treated with Skyrizi had 90% clear skin, only 57% of Cosentyx patients could say the same.

Novartis execs have played down the Skyrizi threat. During a conference call right after the Skyrizi FDA nod became public, then-Novartis pharma chief Paul Hudson said the company didn’t think “there’s anything clinically to be gained” from Skyrizi, adding that more than skin needs to be treated.

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To ensure a successful launch of Skyrizi, AbbVie went as far as discounting Humira to help the new med secure favorable formulary coverage. Early sales figures have been encouraging. In its first full quarter, Skyrizi pulled in $48 million, which CEO Richard Gonzalez characterized as “significantly above our expectations.”

AbbVie also went full power with marketing. In late August, it launched TV ads for Skyrizi, called “Nothing is Everything,” which ranked among pharma’s top TV spenders for several months. It also  started the “Let Me Be Clear” disease campaign on World Psoriasis Day, Oct. 29, with patient stories and a message that encourages more productive discussions with physicians.

During the first quarter of 2020, Skyrizi sales totaled $300 million, on track to blockbuster land. New-to-brand shares have exceeded 30%, Gonzalez said during a conference call in early May. Aiming to expanding Skyrizi into new indications that are also Humira’s territories, AbbVie is expecting data from phase 3 studies in psoriatic arthritis and Crohn’s disease in 2020.

6. Skyrizi