Teva has been dealt a blow as pharmacy benefit manager Express Scripts decided to exclude migraine drug Ajovy from its 2019 formulary, according to data and analytics company GlobalData.
The drug injection, for preventive treatment in adults, received okay from the U.S. Food and Drug Administration in late September, joining a trio of other recently approved or planned migraine treatments.
GlobalData expects the migraine market to experience significant growth over the next 10 years following the 2018-2019 launch of four new monoclonal antibodies: Amgen’s erenumab, Eli Lilly’s galcanezumab, Teva’s fremanezumab, and Alder’s eptinezumab.
“The similarity between products, in terms of both efficacy and safety, and the closeness to launch, had set up an interesting battle for supremacy between Amgen, Eli Lilly, and Teva,” according to Rahael Maladwala, pharma analyst at GlobalData, who added that the lack of coverage by Express Scripts handicaps Teva considerably, leaving Amgen and Eli Lilly fighting for the top spot.
Ajovy and the other CGRP monoclonal antibodies were priced at $6,900 a year in the U.S., slightly below analyst expectations, in moves to bring payers onboard, the analytical firm reported.
“Things are seemingly going from bad to worse at Teva, (which) experienced a bad few years after the disastrous buy out of Allergan’s generics unit,” Maladwala said. “It seems that, despite working for Amgen and Eli Lilly, Express Scripts were not willing to take the risk on Ajovy, after a few manufacturing problems earlier in the year.”
This move is likely to see Ajovy’s forecast sales move from potential blockbuster status to a more conservative estimate, according to the analyst, who warned that if other pharmacy benefit managers follow the Express Scripts decision to exclude the Teva drug, future prospects for Ajovy will be hurt.
Ajovy, a humanized monoclonal antibody that binds to calcitonin gene-related peptide (CGRP) ligand and blocks its binding to the receptor, is the first and only anti-CGRP treatment for the prevention of migraine with quarterly (675 mg) and monthly (225 mg) dosing options. The U.S. Wholesale Acquisition Cost of Ajovy is $575 per monthly dose and $1,725 per quarterly dose. It is available through retail and specialty pharmacies.