AbbVie’s effort to protect Humira’s market share is getting expensive.
On Friday, the company announced a 40% decline in the megablockbuster drug’s US sales for the first quarter. While it managed to hang onto the vast majority of market share, AbbVie did so by offering substantial discounts to compete with the biosimilars that have flooded the market.
While the drop in Humira sales — which made up 18.4% of AbbVie’s worldwide revenue in the first quarter — was better than Wall Street analysts had projected, the company will face far stiffer competition this quarter.
Earlier this month, CVS removed Humira from its formularies to exclusively sell a Sandoz biosimilar called Hyrimoz, and Cigna’s health services arm Evernorth said Thursday it plans to offer a cheaper copycat of Humira for $0 starting in June.
Analysts on Friday’s earnings call pointed to the CVS move and asked AbbVie to clarify its expectations on Humira erosion for the rest of the year, noting execs said that it both “exceeded” and was “in line” with previous guidance. Questions also centered around whether the sales declines would continue to come from the reductions in price, or if it would stem from more physicians prescribing biosimilars, which AbbVie execs call the “price versus volume” dynamic.
Chief commercial officer Jeff Stewart said the CVS removal was anticipated, which is what fell in line with expectations that sales would continue to face pressure through 2024. Humira’s first-quarter sales, meanwhile, came in higher than expected.
Scott ReentsCOO and incoming CEO Rob Michael added that price has accounted for the “vast majority” of the biosimilar uptake, rather than the prescription volume. The price versus volume dynamic is “tracking exactly as we anticipated, so there isn’t an additional downside here,” Michael said.
Earlier this month, Evercore analysts noted CVS’ move increased biosimilar market share up to about 36%, with Hyrimoz making up 93% of those biosimilar sales. AbbVie CFO Scott Reents said Friday that US Humira sales are projected to decline by 32%, with erosion expected to come from more volume pressure.
AbbVie shares $ABBV fell about 3% in early Friday trading.
A tightrope transition
To offset Humira erosion, AbbVie also continues to rely primarily on growing sales from both its Skyrizi and Rinvoq franchises, as well as boosts from its oncology and neuroscience products. In its full-year 2023 update in February, AbbVie raised peak sales estimates of Skyrizi and Rinvoq to $27 billion combined in 2027, up from $21 billion.
Growth continued in the first three months of 2024, as Skyrizi pulled in $2 billion while Rinvoq made $1.09 billion in worldwide sales, respectively increasing by 47.6% and 59.3%. Michael noted that some Humira patients were moving to Skyrizi and Rinvoq to treat their diseases.
Jeff StewartSkyrizi’s increasing growth will likely come from inflammatory bowel disease, following Phase 3 study successes in ulcerative colitis in 2023. AbbVie filed for approval in UC last August with an expected decision in the “middle of this year,” Stewart said. AbbVie previously received an approval for Crohn’s disease in June 2022.
The Rinvoq figures, meanwhile, come after AbbVie said Thursday that it demonstrated superior efficacy to Sanofi’s IL-4/IL-13 inhibitor Dupixent in a post-marketing atopic dermatitis trial, with 19.9% of participants achieving both a 90% or more skin clearance (EASI-90) and almost no itching (WI-NRS) compared to 8.9% of Dupixent patients (p<0.0001).
Leerink analyst David Risinger said Thursday the results were not surprising, as the studies used for Rinvoq’s earlier approvals appeared to show stronger efficacy than those for Dupixent, caveats for cross-trial comparisons included. But he also noted physicians may prefer prescribing Dupixent, given Rinvoq’s black box warning for risks linked to the JAK inhibitor class.
Both the Rinvoq and Dupixent arms had the same rate of serious adverse events (0.9%) in the trial, called LEVEL UP. Last year, Rinvoq made a total of $3.96 billion, while Dupixent raked in €10.72 billion ($11.5 billion) across all indications.