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Analysing the market

    CPhI Worldwide Pre-Show Conference
               CPhI Paris
             4th October 2010
              Peter Wittner
        Interpharm Consultancy

Biosimilars - will they be worth the effort?



                                   1
Analysing the market
 Understanding what makes Biosimilars uptake more
  difficult than generics
       Interchangeability – the big hurdle
 What is the size of the pie? Analysing growth statistics
  and explaining the gap in performance versus potential
       Biotech market is booming but Biosimilars are
           lagging behind
 Identifying the key therapeutic areas for Biosimilars
       Do the numbers tell us the whole story?
 Where are the future opportunities for greatest growth?
       US, EU or India?
       Where should you invest?
                                           2
What makes Biosimilars uptake
    more difficult than generics?
Interchangeability – the big hurdle




                                       3
What is the size of the pie?




              i lar
           sim ce
         io l i
        B s




How big will the Biosimilars slice be?
                             4
What is the size of the pie?
Leading Biological products 2009
                                                                         2009    2008
           Brand                Generic           Company
                                                                         Sales Sales
Enbrel                       Etanercept       Amgen / Wyeth               $6,580 $6,490
Remicade                     Infliximab       Centocor / Schering Plough $5,934 $5,335
Avastin                      Bevacizumab Genenetech / Roche               $5,777 $4,484
                                              Genenetech / Roche /
Rituxan / MabThera           Rituximab        Biogen-IDEC                 $5,653 $5,099
Humira Pen                   Adalimumab Abbott / Eisai                    $5,488 $4,521
                                              Amgen / Ortho / Janssen-
Epogen / Procrit / ESPO      Epoetin Alpha Cilag / Kyowa Hakko            $5,033 $5,123
Herceptin                    Trastuzumab Genentech / Roche / Chugai $4,890 $4,384
Lantus                       Insulin glargine Sanofi-Aventis              $4,185 $3,130
Neulasta                     Pegfilgrastim Amgen                          $3,355 $3,318
Aranesp                      Darbopoetin Amgen / Kyowa Hakko              $2,871 $3,334
                                                         +10%
Source: La Merie report – Top 20 Biologics 2009                       $49,766 $45,218
                                                                  5
What is the size of the pie?
Biotech market value is mainly concentrated in
           Western markets............
                     Biological products 2009
$5.0                     Sales in $b n. Source: IMS           Europe
$4.5                                                          US
$4.0     $2.0
                 $1.4      $1.5
$3.5                                 $2.0      $1.6   $1.5
$3.0                                                         $1.0
$2.5
$2.0
$1.5     $3.0     $3.0      $2.8               $2.6   $2.5   $2.4
                                      $2.3
$1.0
$0.5
$0.0
       Enbrel Remicade Avastin Humira Lovenox Mabthera Lantus
                                                         6
What is the size of the pie?
.... but most of world population and the Biosimilar
   consumer base is in low-cost developing markets
                    W orld population breakdown

                              14.8%        0.5% 8.7%
                                                           5.0%
                                                              3.1%
                                                                    11.9%



                              56.0%




         A frica              A sia               E uro p e                M iddle E ast
         N o rt h A m erica   L at in A m erica   Ocean ia / A ust ralia
                              /Caribbean


                                                                           7
Why is the biological market growing?

 Big Pharma is moving up market
    Biologicals are higher priced than small molecule
     medicines
    Biologicals are harder to copy = technological barrier
 Biologicals pricing – some US figures from GPhA
    In the US the lung cancer drug Avastin costs about
     $100,000 per patient per year
    The cost for Cerezyme used to treat Gaucher disease,
     can run to $300,000 / patient / year
    Projected savings are between $42- $108 bn over the
     first 10 years of a US Biosimilar market

                                             8
What makes Biosimilars uptake
    more difficult than generics?
Let’s compare with normal generics
Look at what will certainly happen with Atorvastatin
   The SPC expires November 2011
   Based on precedent, around 20 companies will launch on
    the day after the expiry
   All will have been accepted as “essentially similar” to
    Lipitor by the regulators
   All can therefore be substituted in place of the original
    brand and each other
In other words, there is complete interchangeability
                                             9
Interchangeability – why is it an issue?

 Marketing biosimilars is not the same as
  marketing generics
 The big issue is interchangeability
 Or perhaps the real issue is the lack of it
 Prescribers need to be convinced that A = B or
  else they will not substitute when prescribing
 If Biosimilars cannot be prescribed by INN
  name, the pharmacist cannot substitute

                                       10
What makes Biosimilars uptake
    more difficult than generics?
Interchangeability – experience in EU markets
 shows that prescribers are reluctant to switch
     Most EU countries require prescription of biological
      products by brand name
     Prescribers are therefore waiting until they see a
      newly diagnosed patient before trying Biosimilar
Result – very slow market penetration by
 Biosimilars
Amgen claims it has only lost 3% MS to Filgrastim
 (G-CSF) copies
                                           11
What has happened so far?




Source: Amgen Q1 ’10
Earnings Call                   12
What has happened so far?
“Bringing a Biosimilar to market takes up
to eight years, with development costs
averaging $100-$150 million.

Last year, sales of biosimilars reached just
$75 million worldwide compared with
$110 billion in sales of biologic drugs”
Greg Perry, EGA, speaking at 8th EGA International Symposium on Biosimilar
Medicines, 2nd September 2010 reported by Pharma Times



                                                         13
Biosimilars marketplace
 Who will be the major players?
 In Western markets.....
      Only companies with deep pockets!
      Biosimilars have to be marketed, not just sold
      That means Teva, Sandoz, Hospira
 In Eastern and emerging markets
      The barriers to entry are lower
      The market is more a classic generic market -
       PRICE!
      Ranbaxy, Dr. Reddys, Biocon are already there
                                            14
Biosimilars marketplace
It is not just the generic companies that are
 thinking about entering the market
     2008 – Merck & Co announces plans for unit to
      copy biotech medicines. Aim is to sell at least six
      biogenerics by 2017
     2009 – Eli Lilly acquires Imclone Systems and
      announces initiative to develop biosimilars
     2009 – AstraZeneca says it is considering
      participation in biosimilars market
     Jan 2010 – Pfizer says it plans to launch
      biosimilars of leading 10–15 biologicals

                                           15
Biosimilars – Big Pharma
Pfizer wants to enter China using locally made
 copy biologicals with Pfizer / Wyeth brand
GSK will buy biosimilars from Biocon (India) for
 Pharmerging markets
Sanofi-Aventis is also planning to target
 Pharmerging markets with Biosimilars
Bayer-Schering is selling Gensulin from Bioton
 (Poland) and Insugen from Biocon in China


                                    16
Key therapeutic areas for
              Biosimilars
This is another area where market figures alone
 will not be a good guide
Market data seems to show MAbs taking a
 growing market share
      But what data will the regulators want to
       allow you to register your copy?
       The rate limiting step in regulated markets is going
        to be the need for regulators to provide guidelines


                                             17
Where are the future opportunities
       for greatest growth?
US, EU or India?
     US biological prices are under pressure but should
      stay high
EU – price competition is growing
       More Biosimilars entering the market and slow
        uptake will inevitably push prices down
India – low prices
     But market entry is easier and volumes are huge
Where should you invest?
                                           18
Asian markets – India
            Changes in G-CSF (Filgrastim) prices in
                  response to competition
  6,000



  5,000



  4,000
R              Inno vato r
u              Bio similar
p
e 3,000
e
s
  2,000



  1,000



     0
     2002    2003            2004        2005          2006           2007        2008


                                    Source: Biocon presentation, Biosimilars India 2009
                                                                 19
Asian markets – India
  Comparing Indian Biological prices to the rest of the world


     Substance          Average      Average    Differential
                       world price Indian price     in %
     Human Insulin     U$ / 100 IU vial US$6.50 / 100 IU
                                              vial              80%
      Anti-EFGR          $25,000 per       $6,000 per
      Monoclonal          treatment         treatment           75%
      Recombinant
      streptokinase
                          $150 / vial       $10 / vial          95%
          EPO          $200 / 2,000 IU    $10 / 2,000 IU        95%

Source: Biocon (Biosimilars India 2009)

                                                           20
Where are the future opportunities
       for greatest growth?
So where should you invest?
India / Asia / Latin America for quick returns
     Market entry is quicker and cheaper, prices are
      lower, but compensation is the high volumes
EU/USA for longer term stability and higher
 margins
     Market entry is slower and much more costly, but
      the compensation will be long-term stability and
      higher prices

                                           21
Any questions?
Mail me if you think of them later
  peter@interpharm-consultancy.co.uk




                             22

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Biosimilars - analysing market intelligence (Peter Wittner)

  • 1. Analysing the market CPhI Worldwide Pre-Show Conference CPhI Paris 4th October 2010 Peter Wittner Interpharm Consultancy Biosimilars - will they be worth the effort? 1
  • 2. Analysing the market  Understanding what makes Biosimilars uptake more difficult than generics  Interchangeability – the big hurdle  What is the size of the pie? Analysing growth statistics and explaining the gap in performance versus potential  Biotech market is booming but Biosimilars are lagging behind  Identifying the key therapeutic areas for Biosimilars  Do the numbers tell us the whole story?  Where are the future opportunities for greatest growth?  US, EU or India?  Where should you invest? 2
  • 3. What makes Biosimilars uptake more difficult than generics? Interchangeability – the big hurdle 3
  • 4. What is the size of the pie? i lar sim ce io l i B s How big will the Biosimilars slice be? 4
  • 5. What is the size of the pie? Leading Biological products 2009 2009 2008 Brand Generic Company Sales Sales Enbrel Etanercept Amgen / Wyeth $6,580 $6,490 Remicade Infliximab Centocor / Schering Plough $5,934 $5,335 Avastin Bevacizumab Genenetech / Roche $5,777 $4,484 Genenetech / Roche / Rituxan / MabThera Rituximab Biogen-IDEC $5,653 $5,099 Humira Pen Adalimumab Abbott / Eisai $5,488 $4,521 Amgen / Ortho / Janssen- Epogen / Procrit / ESPO Epoetin Alpha Cilag / Kyowa Hakko $5,033 $5,123 Herceptin Trastuzumab Genentech / Roche / Chugai $4,890 $4,384 Lantus Insulin glargine Sanofi-Aventis $4,185 $3,130 Neulasta Pegfilgrastim Amgen $3,355 $3,318 Aranesp Darbopoetin Amgen / Kyowa Hakko $2,871 $3,334 +10% Source: La Merie report – Top 20 Biologics 2009 $49,766 $45,218 5
  • 6. What is the size of the pie? Biotech market value is mainly concentrated in Western markets............ Biological products 2009 $5.0 Sales in $b n. Source: IMS Europe $4.5 US $4.0 $2.0 $1.4 $1.5 $3.5 $2.0 $1.6 $1.5 $3.0 $1.0 $2.5 $2.0 $1.5 $3.0 $3.0 $2.8 $2.6 $2.5 $2.4 $2.3 $1.0 $0.5 $0.0 Enbrel Remicade Avastin Humira Lovenox Mabthera Lantus 6
  • 7. What is the size of the pie? .... but most of world population and the Biosimilar consumer base is in low-cost developing markets W orld population breakdown 14.8% 0.5% 8.7% 5.0% 3.1% 11.9% 56.0% A frica A sia E uro p e M iddle E ast N o rt h A m erica L at in A m erica Ocean ia / A ust ralia /Caribbean 7
  • 8. Why is the biological market growing?  Big Pharma is moving up market  Biologicals are higher priced than small molecule medicines  Biologicals are harder to copy = technological barrier  Biologicals pricing – some US figures from GPhA  In the US the lung cancer drug Avastin costs about $100,000 per patient per year  The cost for Cerezyme used to treat Gaucher disease, can run to $300,000 / patient / year  Projected savings are between $42- $108 bn over the first 10 years of a US Biosimilar market 8
  • 9. What makes Biosimilars uptake more difficult than generics? Let’s compare with normal generics Look at what will certainly happen with Atorvastatin  The SPC expires November 2011  Based on precedent, around 20 companies will launch on the day after the expiry  All will have been accepted as “essentially similar” to Lipitor by the regulators  All can therefore be substituted in place of the original brand and each other In other words, there is complete interchangeability 9
  • 10. Interchangeability – why is it an issue?  Marketing biosimilars is not the same as marketing generics  The big issue is interchangeability  Or perhaps the real issue is the lack of it  Prescribers need to be convinced that A = B or else they will not substitute when prescribing  If Biosimilars cannot be prescribed by INN name, the pharmacist cannot substitute 10
  • 11. What makes Biosimilars uptake more difficult than generics? Interchangeability – experience in EU markets shows that prescribers are reluctant to switch  Most EU countries require prescription of biological products by brand name  Prescribers are therefore waiting until they see a newly diagnosed patient before trying Biosimilar Result – very slow market penetration by Biosimilars Amgen claims it has only lost 3% MS to Filgrastim (G-CSF) copies 11
  • 12. What has happened so far? Source: Amgen Q1 ’10 Earnings Call 12
  • 13. What has happened so far? “Bringing a Biosimilar to market takes up to eight years, with development costs averaging $100-$150 million. Last year, sales of biosimilars reached just $75 million worldwide compared with $110 billion in sales of biologic drugs” Greg Perry, EGA, speaking at 8th EGA International Symposium on Biosimilar Medicines, 2nd September 2010 reported by Pharma Times 13
  • 14. Biosimilars marketplace  Who will be the major players?  In Western markets.....  Only companies with deep pockets!  Biosimilars have to be marketed, not just sold  That means Teva, Sandoz, Hospira  In Eastern and emerging markets  The barriers to entry are lower  The market is more a classic generic market - PRICE!  Ranbaxy, Dr. Reddys, Biocon are already there 14
  • 15. Biosimilars marketplace It is not just the generic companies that are thinking about entering the market  2008 – Merck & Co announces plans for unit to copy biotech medicines. Aim is to sell at least six biogenerics by 2017  2009 – Eli Lilly acquires Imclone Systems and announces initiative to develop biosimilars  2009 – AstraZeneca says it is considering participation in biosimilars market  Jan 2010 – Pfizer says it plans to launch biosimilars of leading 10–15 biologicals 15
  • 16. Biosimilars – Big Pharma Pfizer wants to enter China using locally made copy biologicals with Pfizer / Wyeth brand GSK will buy biosimilars from Biocon (India) for Pharmerging markets Sanofi-Aventis is also planning to target Pharmerging markets with Biosimilars Bayer-Schering is selling Gensulin from Bioton (Poland) and Insugen from Biocon in China 16
  • 17. Key therapeutic areas for Biosimilars This is another area where market figures alone will not be a good guide Market data seems to show MAbs taking a growing market share But what data will the regulators want to allow you to register your copy?  The rate limiting step in regulated markets is going to be the need for regulators to provide guidelines 17
  • 18. Where are the future opportunities for greatest growth? US, EU or India?  US biological prices are under pressure but should stay high EU – price competition is growing  More Biosimilars entering the market and slow uptake will inevitably push prices down India – low prices  But market entry is easier and volumes are huge Where should you invest? 18
  • 19. Asian markets – India Changes in G-CSF (Filgrastim) prices in response to competition 6,000 5,000 4,000 R Inno vato r u Bio similar p e 3,000 e s 2,000 1,000 0 2002 2003 2004 2005 2006 2007 2008 Source: Biocon presentation, Biosimilars India 2009 19
  • 20. Asian markets – India Comparing Indian Biological prices to the rest of the world Substance Average Average Differential world price Indian price in % Human Insulin U$ / 100 IU vial US$6.50 / 100 IU vial 80% Anti-EFGR $25,000 per $6,000 per Monoclonal treatment treatment 75% Recombinant streptokinase $150 / vial $10 / vial 95% EPO $200 / 2,000 IU $10 / 2,000 IU 95% Source: Biocon (Biosimilars India 2009) 20
  • 21. Where are the future opportunities for greatest growth? So where should you invest? India / Asia / Latin America for quick returns  Market entry is quicker and cheaper, prices are lower, but compensation is the high volumes EU/USA for longer term stability and higher margins  Market entry is slower and much more costly, but the compensation will be long-term stability and higher prices 21
  • 22. Any questions? Mail me if you think of them later peter@interpharm-consultancy.co.uk 22