By Will Roettger
Principal Consultant
20/20 Market Insights, LLC
June 17, 2004
Will Roettger is an established career professional in the
pharmaceutical and biotech industry. Having worked for Novartis,
AstraZeneca, Merck, Alexion, and Dendreon he has developed
expertise across the therapeutic areas of oncology, hematology, and
immunology for pipeline and launch products. He has been
instrumental in establishing marketing intelligence as a core capability
in support of clinical and commercial new product development, solving
the many commercial challenges that high-priced specialty products
face from a patient, provider, and investor perspective. Additionally he
has supported two specialty product launches, providing actionable
insights and recommendations by integrating market research findings
with competitive intelligence. As a principal for 20/20 Market Insights,
LLC, he is dedicated to providing clients with clear vision into
competitor landscapes, strategies, and product assessments that drive
strategic business decisions in new drug development.
Contact Information:
Will Roettger

Principal Consultant
20/20 Market Insights, LLC
908-391-4362
will.roettger@gmail.com
2
This is a briefing on the launch uptake of Avastin and Erbitux. With initial product uptake
data we can now assess how effective the clinical trial development programs were of
these two products and retrospectively mine for best practice strategies.
Erbitux: ImClone generated $17.5 Million (1st quarter sales) in the first 27 days post
launch. For estimation purposes, lets take the 27-day sales of $17.5 M, assume CRC only
use, a zero ramp up, annualize the 27-days sales data to get a rough estimation of Erbitux
year end sales revenue. Projected Erbitux year end sales could be ~ $194 Million in
2004.
Avastin: We can perform the same estimation on Avastin with $38 Million (1st quarter
reported sales) in the first 27-days post launch. Assume CRC only use, a zero ramp up,
monthly order of 1, annualize the 27-days of sales, deduct $21 Million of product stock
to get a rough estimation of Avastin year end sales revenue. Projected Avastin year end
sales would be ~ $402 Million in 2004.
Launch

A

E

Source: Tandem Cancer Audit, April 2004
Rolling 3-Month Report, Metastatic CRC
Launch

1st line CRC indication
2nd line CRC indication

Source: IntrinsiQ Research Audit, April 2004
Monthly Report, Stage IIIb/IV, All Lines, CRC
Launch

1st line CRC indication

2nd line CRC indication

Source: IntrinsiQ Research Audit, April 2004
Monthly Report, Stage IIIb/IV, All Lines, CRC
Treatment

Dec 03 –
Feb 04

Jan 04 –
Mar 04

Feb 04 –
Apr 04

% Change
Jan 04 – Feb 04

Avastin

3.2%

4.3%

11.2%

160.5%

Erbitux

0.5%

4.5%

7.7%

71.1%

Source: Tandem Cancer Audit, April 2004
Rolling 3-Month Report, Metastatic CRC
Source: S.G. Cowen & Co., LLC – Avastin/Erbitux Tracking Study,
April 2004 report, Presentation Slides
Source: S.G. Cowen & Co., LLC – Avastin/Erbitux Tracking Study,
April 2004 report, Presentation Slides
Launch

Source: Tandem Cancer Audit, April 2004
Rolling 3-Month Report, Metastatic CRC
Share of Stage IIIb/IV CRC
Patients
Launch

Source: IntrinsiQ Research Audit, April 2004
Monthly Report, Stage IIIb/IV, All Lines, CRC
Will	
  Roettger	
  

Principal	
  Consultant	
  
20/20	
  Market	
  Insights,	
  LLC	
  
908-­‐391-­‐4362	
  
will.roettger@gmail.com	
  

16

Avastin & Erbitux Launch in in CRC - Key Learnings and Implications (061704)

  • 1.
    By Will Roettger PrincipalConsultant 20/20 Market Insights, LLC June 17, 2004
  • 2.
    Will Roettger isan established career professional in the pharmaceutical and biotech industry. Having worked for Novartis, AstraZeneca, Merck, Alexion, and Dendreon he has developed expertise across the therapeutic areas of oncology, hematology, and immunology for pipeline and launch products. He has been instrumental in establishing marketing intelligence as a core capability in support of clinical and commercial new product development, solving the many commercial challenges that high-priced specialty products face from a patient, provider, and investor perspective. Additionally he has supported two specialty product launches, providing actionable insights and recommendations by integrating market research findings with competitive intelligence. As a principal for 20/20 Market Insights, LLC, he is dedicated to providing clients with clear vision into competitor landscapes, strategies, and product assessments that drive strategic business decisions in new drug development. Contact Information: Will Roettger Principal Consultant 20/20 Market Insights, LLC 908-391-4362 will.roettger@gmail.com 2
  • 4.
    This is abriefing on the launch uptake of Avastin and Erbitux. With initial product uptake data we can now assess how effective the clinical trial development programs were of these two products and retrospectively mine for best practice strategies.
  • 5.
    Erbitux: ImClone generated$17.5 Million (1st quarter sales) in the first 27 days post launch. For estimation purposes, lets take the 27-day sales of $17.5 M, assume CRC only use, a zero ramp up, annualize the 27-days sales data to get a rough estimation of Erbitux year end sales revenue. Projected Erbitux year end sales could be ~ $194 Million in 2004. Avastin: We can perform the same estimation on Avastin with $38 Million (1st quarter reported sales) in the first 27-days post launch. Assume CRC only use, a zero ramp up, monthly order of 1, annualize the 27-days of sales, deduct $21 Million of product stock to get a rough estimation of Avastin year end sales revenue. Projected Avastin year end sales would be ~ $402 Million in 2004.
  • 6.
    Launch A E Source: Tandem CancerAudit, April 2004 Rolling 3-Month Report, Metastatic CRC
  • 7.
    Launch 1st line CRCindication 2nd line CRC indication Source: IntrinsiQ Research Audit, April 2004 Monthly Report, Stage IIIb/IV, All Lines, CRC
  • 8.
    Launch 1st line CRCindication 2nd line CRC indication Source: IntrinsiQ Research Audit, April 2004 Monthly Report, Stage IIIb/IV, All Lines, CRC
  • 9.
    Treatment Dec 03 – Feb04 Jan 04 – Mar 04 Feb 04 – Apr 04 % Change Jan 04 – Feb 04 Avastin 3.2% 4.3% 11.2% 160.5% Erbitux 0.5% 4.5% 7.7% 71.1% Source: Tandem Cancer Audit, April 2004 Rolling 3-Month Report, Metastatic CRC
  • 10.
    Source: S.G. Cowen& Co., LLC – Avastin/Erbitux Tracking Study, April 2004 report, Presentation Slides
  • 11.
    Source: S.G. Cowen& Co., LLC – Avastin/Erbitux Tracking Study, April 2004 report, Presentation Slides
  • 12.
    Launch Source: Tandem CancerAudit, April 2004 Rolling 3-Month Report, Metastatic CRC
  • 13.
    Share of StageIIIb/IV CRC Patients Launch Source: IntrinsiQ Research Audit, April 2004 Monthly Report, Stage IIIb/IV, All Lines, CRC
  • 16.
    Will  Roettger   Principal  Consultant   20/20  Market  Insights,  LLC   908-­‐391-­‐4362   will.roettger@gmail.com   16

Editor's Notes

  • #6 In this slide I have combined all of the Erbitux utilization into one line and have done the same with Avastin in order to see the growth of the product relative to the other treatment regimens. This clearly visualizes the steepness of the growth of both agents. If Avastin maintains this growth curve, without question it will be the most successful oncology product launched. Erbitux will be in a close second to Avastin, although with such a strong showing at ASCO in SCCHN, off label use could provide a substantial boost Erbitux total sales that could make it a close race.
  • #9 This chart combines all use of Avastin use into one line and the same for Erbitux. From this chart we can clearly see the strength of the growth for Avastin and Erbitux since launch in Feb 04. Avastin and Erbitux growth (as reported by rolling 3-month ending March 04 to April 04) is 160.5% and 71.1%, respectively.
  • #10 This is a slide taken form the SG Cowen study depicting Avastin current versus 6-month uptake. If we assume that the change between current and 6-month penetration represents growth, we can compare this to our Tandem data. Avastin’s projected share of nearly 60% in 1 st line patients within a short 6-months is an extremely rapid uptake. This would depict a ramp-up of 152% in a short period of time, clearly one of the fastest launch uptakes in oncology. In comparison to the Tandem data (161%), 1 st line Avastin uptake of 152% in this SG Cowen study are comparable..
  • #11 This is a slide taken form the SG Cowen study depicting Erbitux current versus 6-month uptake. If we assume that the change between current and 6-month penetration represents growth, we can compare this to our Tandem data. Erbitux’s projected share of nearly 39% in 3 rd line patients within a short 6-months is an extremely rapid uptake. This would depict a ramp-up of 70% in a short period of time. In comparison to the Tandem data (71%), 1 st line Erbitux uptake of 70% in this SG Cowen study are comparable..
  • #12 This data is from our second source – Tandem . As per indication, Avastin combined with the SALTZ regimen is showing the quickest uptake, second only to Avastin combined with 5FU/LV, and third to Avastin plus FOLFOX. Avastin combinations with SALTZ, 5FU/LV, and FOLFOX are all paralleling in growth curves depicting perhaps a gold standard in the making. This could be the early signs of physicians utilizing Avastin as the key agent while chemotherapy treatment regimens are traded on and off based upon response and patient type. It is not surprising that the Avastin/FOLFOX regimen is the slowest in uptake perhaps due one or more reasons: not having an indication with the FOLFOX regimen, study results not yet released on Avastin/FOLFOX, all patients eligible to be on Avastin/FOLFOX are in trials, the excessive cost of combining with already high priced Oxaliplatin. In the near future as new data is released on the efficacy of Avastin/ FOLFOX, increase utilization of this combination regimen is expected to push its growth beyond that of the 5FU/LV/Avastin combination. The Avastin/Xelox treatment regimen has garnered some usage, although minimal compared to the standard combinations. Erbitux is primarily being used as Erbitux/Irinotecan or as a monotherapy. The triplet, Cetuximab/SALTZ, has received some use although minimal. This may be due to the indicated use of Erbitux in latter lines of treatment and also to the negatively synergistic adverse events of the combination itself.
  • #13 This data is from IntrinsiQ . Clearly depicts rapid uptake of Avastin in a broad range of combinations. Although Avastin use is in primarily in combination with FOLFOX, Saltz, and 5FU – utilization is spread among other doublet and triplet treatment regimens as well. This demonstrates a nice broad utilization, supported by a broad clinical development plan.