The biggest-selling drug in 2018 will be…

EvaluatePharma, a UK based company specializing in pharma and biotech analysis has been gazing long and hard into its crystal ball.

Having scrutinized the world’s leading 3,500 pharmaceutical and biotech companies they have come up with a list of what, they believe, will be the top 10 selling drugs in 2018.

  1. Januvia       (diabetes) – $9.7 billion
  2. Humira        (arthritis) – $8.2 billion
  3. Avastin        (cancer) – $7.5 billion
  4. Enbrel          (arthritis)  – $7.2 billon
  5. Revlimid     (myelodysplastic syndrome) – $6.75 billion
  6. Prevnar 13  (pneumococcal vaccine) – $6.72 billion
  7. Rituxan         (cancer) – $6.3 billion
  8. Lantus           (diabetes) – $5.9 billion
  9. Remicade     (arthritis) – $5.8 billion
  10. Advair            (COPD)  – $5.7 billion

Surprised?  No conventional molecules, no cholesterol lowering agents, no blood pressure meds and not a single new drug among the top ten.  However, they predict the #11 best seller will be GS-7977 – the much anticipated oral hepatitis C drug from Gilead Sciences .

Not so surprising, given the obesity epidemic sweeping the western world that 2 of the front runners are diabetes drugs. Likewise, given the globally aging population – 3 are for arthritis.

#5 may be a surprise to many. Few people had ever heard of myelodysplastic syndrome before ABC news anchor Robin Roberts announced last week that she has the disease.  Still, it’s predicted number 5 status doesn’t mean that an epidemic is expected – it’s still relatively rare with only 10,000 or so new cases detected each year. Its lofty status on the list is more to do with the price. It costs a staggering $10,000 or so for a 28 day supply of the pills.

Other predictions from the EvaluatePharma World Preview 2018 report:

  • Worldwide prescription drug sales are forecast to total $885bn in 2018 an increase of 3.1% from 2011
  • Over $290bn of pharmaceutical sales are at risk from patent expirations between now and 2018
  • Pfizer was the top company for prescription drug sales in 2011, but  Novartis will top the list by 2018
  • Global pharmaceutical R&D spend forecast will grow by 1.5% per year to $149bn in 2018
  • Anti-coagulants (blood thinners) are set to record highest growth of major therapy categories to 2018

Interesting stuff. But the problem with such long term predictive models is that they are but a snapshot  trying to project out six years.

In reality, life is a movie, with a frequently changing plot. For example if J&J’s canagliflozin can reduce obesity and improve blood sugar levels better than Januvia then the projected No. 1 ranking is suspect, at best.

Pediatric Wheezers not such Wizards with Puffers

Regular readers of SRxA’s  Word on Health already know that asthma is the most common chronic childhood disease in the U.S. Direct asthma-related healthcare costs are upwards of $ 6 billion a year and lost productivity costs associated with working parents caring for children who miss school, costs a further billion. Given this huge financial burden we were shocked to learn that fewer than one in 10 children with asthma use their inhalers correctly.

While children have more success with newer inhaler designs, at best, only one child in four gets it completely right, according to the findings published in the journal Pediatrics.

Researchers from the University of North Carolina at Chapel Hill, Eshelman School of Pharmacy studied 296 patients aged 8 to 16 years old who used four different devices to manage their asthma.

The devices were:

  • metered-dose inhaler (commonly called a puffer)
  • diskus, (a dry-powder inhaler delivering Advair)
  • turbuhaler (a dry-powder inhaler delivering Pulmicort or Symbicort)
  • peak-flow meter, which does not deliver a drug but is used to measure lung function to determine if medicine is needed

Only 8% of children in the study performed all of the metered-dose inhaler steps correctly. Older children were more likely than younger children to get more of the metered-dose inhaler steps correct. With a diskus, 22% of children performed all steps correctly, and 15.6% performed all of the turbuhaler steps correctly. Children using a peak-flow meter did so correctly 24% of the time.

The researchers also found that the majority of health-care providers who participated in the study did not demonstrate or assess children’s use of the four devices during pediatric asthma visits.

It is crucial that health-care providers not only show a child how to use an inhaler correctly but also have the child demonstrate the device in front of a physician or pharmacist,” said lead investigator Betsy Sleath Ph.D. “Pediatric practices are extremely busy places so we need innovative ways to demonstrate and assess device technique among asthmatic children.”

Improper use of inhalers and other asthma medication devices can lead to poor control of the condition, more hospitalizations and increased health-care costs.

SRxA’s team of leading asthma experts can help design programs to teach healthcare professionals how to teach patients about their asthma therapy.  These validated programs have been shown to dramatically increase compliance and adherence.  Contact us today to learn more.

Advair Diskus Warning Issued By FDA Over Stolen Asthma Inhalers

Federal drug regulators and law enforcement officials are warning physicians, pharmacists and patients to be on the lookout for stolen Advair Diskus inhalers.

The FDA issued a stolen Advair Diskus warning on July 16, alerting consumers and pharmacists that Advair inhalers, stolen in 2009, have been turning up in pharmacies. The FDA warns that the effectiveness and safety of these asthma inhalers cannot be verified as the distribution channel integrity has been breached.

The inhalers were stolen in a Hollywood-style heist last August from a GlaxoSmithKline warehouse in Chesterfield, Virginia. Police say the thieves cut a hole in the ceiling and rappelled down using a trapeze-like device, swiping 25,600 inhalers worth more than $6 million. Law enforcement officials say they suspect the same group was responsible for an even more spectacular robbery at an Eli Lilly warehouse in Connecticut in March, where they again cut a hole in the roof and rappelled to the floor, getting away with $75 million in drugs.

The FDA warns that the stolen inhalers include 60-dose Advair Diskus 250/50 inhalers with a lot number of 9ZP2255 – NDC 0173-0696-00, and 60-dose Advair Diskus 500/50 inhalers with a lot number of 9ZP3325 – NDC 0173-0697-00.

According to FDA, the drugs may have been compromised by being stored in the wrong temperature or humidity, may have been tampered with or could have become contaminated.

The agency is urging anyone who has purchased an inhaler from the affected lots to stop using them immediately, contact GlaxoSmithKline and follow up with their physician or pharmacist to get a replacement. The FDA also urges any pharmacists or wholesalers who find the stolen drugs on their shelves to contact the FDA’s Office of Criminal Investigations at www.fda.gov/oci.

Breathing Easy

SRxA is pleased to report that it has been a week of good news for two of the top players in the pharmaceutical industry.

First, GlaxoSmithKline announced that they see little threat of generic competition for their asthma and COPD drug Advair® (fluticasone propionate and salmeterol inhalation powder) when it comes off patent in the US in 2011.  Noting that “it is very difficult to make a generic version of Advair,” GSK’s CEO, Andrew Witty, told the audience of a JP Morgan healthcare conference that “we are working on the basis of substantial Advair business for the foreseeable future.”

Shortly thereafter, in a separate announcement, the FDA noted that it completed the safety review of Pfizer and Boehringer Ingelheim‘s once daily COPD drug, Spiriva® (tiotropium bromide inhalation powder) and came to the conclusion that “available data do not support an association” between use of the drug and increased risk of stroke, heart attack or death due to cardiovascular causes.  The safety review was initiated in 2008 after data from a meta-analysis suggested a small excess risk of stroke compared with placebo.

Word on Health hopes that the new year will continue to bring good news for pharma.