The exodus hasn’t really begun yet. There are so many things to address here, where shall I begin. Why don’t we start with what’s known? Goals are messed up again, Glitchy Mitchy still can’t come up with an equitable way to divide the unrealistic goals around the country. Have heard from Taro, DUSA and Absorica reps that there is unevenness in the distribution. Some reps have been given goals that are not even a gimme, but a pure slam dunk, while others will toil away making zero again for months.
Tildra is a joke, expectations are so high and in the field there is no excitement at all from the doctors. In fact, most think it’s a joke. Taltz couldn’t be given away to insurance companies, Humira just dominates. Why would they pickup a less than effective late to market product from a company that refuses to bargain?
Sun Pharma, on Tuesday reported that it has received USFDA approval for its biologic drug Tildrakizumab (Ilumya) for the treatment of plaque psoriasis. However, the company had not provided any launch dates for this drug. Nonetheless, the pharma major is now hiring salespersons and creating an infrastructure as part of its commercialization plan for the US market.
Biologic drugs are gaining popularity all over all the world due to their high efficacy. In case of psoriasis treatment, biologics are gaining market share despite their high costs. Drugs like Humira, which is also prescribed for psoriasis treatment, generated more than $18.4bn sales in 2017. Humira manufacturer, Abbvie expects the drug to clock peak sales of ~$21bn in 2021.
Considering the prospects of biologics, the approval of Tildrakizumab should have lifted the spirits of Sun Pharma's shareholders. However, investors gave the shares of the company a miss in Wednesday's trade, suggesting that the Indian markets are skeptical of Tildrakizumab performance in the US market. So, what is happening?
Psoriasis market is competitive
The Psoriasis biologics market is already crowded. There was a time when psoriasis biologics based on Tumor Necrosis Factor (TNF) inhibitors such as Cimzia, Enbrel, Humira and Remicede, were popular. The advent of next generation interleukin (IL) inhibitors (better than TNF inhibitors) however has changed the scenario. These IL based biologics have unprecedented efficacy of complete skin clearance compared to older biologics such as TNF inhibitors.
There are two different Interlukins (IL-17 and IL-23) being targeted in the psoriasis treatment. The IL-17 inhibitor biologics are sold under brands Stelara (Ustekinumab), Cosentyx (Secukinumab), Taltz (Ixekizumab) and Siliq (Brodalumab). The two IL-23 targeting approved biologics are Tremfyaa (Guselkumab) and Sun Pharma Ilumya (Tildrakizumab). The IL-23 inhibitor biologics require fewer injections, and hence, they are gaining popularity. While Sun Pharma’s Ilumya has received a USFDA approval, it is far behind Tremfyaa, which has best in class cure rate (PASI 75 rating). Ilumya also lags behind other IL-17 targeting biologics.
Tildrakizumab is not best in class, Risankizumab to change the competitive scenario
The positive for Sun Pharma’s shareholders is that Tildrakizumab is a latest IL-23 targeting biologic drug. The subpar PASI-75 score than the peers, however is a concern area and may not be able to generate high market share or become a blockbuster drug (annual sales over >1bn). It would also not be able to get premium price that is being charged its fello IL-23 targeting biologic, Tremfyaa ($58,100 a year). Ilumya is likely to be priced around $40,000 a year.
The ramp-up is expected to be gradual and it may gain 6-7% market share (in psoriasis biologics). We estimate peak sales of ~$700mn in FY22, post which we expect entry of Risankizumab (innovator Abbvie), another IL23 targeting drug, which has better PASI 75 score than Ilumya and best in class PASI-100 score. Risankizumab is in phase III clinical trial at the moment. The entry of Risankizumab will change the competitive landscape significantly
And this is the big one, rumor has it that HR over ruled field managers on review scores! Some top reps dropped to create a better bell curve. You may think you’re getting a solid review based on the efforts you put in, but prepare yourself for less than that. How you ranked out the year will determine your review score. Pay increases will follow your score, so don’t look forward to a standard 3% bump, you may get only 1% or possibly 0!
Abhay and Dilip care about one thing only profit. Yes it’s their job, however, they talk about people and the vision of Sun, but it’s a lie. Price increases, dropped coverage, unreal goals, and indifference to the sales team shows who they reall are.
