Pricing pressure caused two of Eli Lilly’s key growth products to miss sales targets in the first quarter, causing it to cut its full-year sales forecast.
Lower-than-expected sales for psoriasis drug Taltz (ixekizumab) and Trulicity (dulaglutide) for diabetes were put down to increasing demand in the US market for rebates and discounts.
Lilly was still able to post modest sales growth of 3% to $5.1bn, despite the ongoing impact of generic competition to its big-selling erectile dysfunction drug Cialis (tadalafil), but that was upwards of $100m below analyst expectations.
IL-17 inhibitor Taltz grew 72% to $253m in the quarter, but increased volumes were offset by lower “realised prices” for the drug. That scenario also applied to Trulicity – the first once-weekly GLP-1 agonist to reach the market – which rose 30% to $880m.
Both drugs are also facing competition in the market, which allows healthcare payers to negotiate hard on access to formularies. For Trulicity, rival Ozempic (semaglutide) from Novo Nordisk is starting to gain ground thanks to new cardiovascular outcomes data, while Taltz is expected to face a tough challenge from AbbVie’s recently-approved IL-23 inhibitor Skyrizi (risankizumab).
Taltz and Trulicity collectively underperformed by around $120m, according to some analyst estimates, and overall prices were 3% lower with another 2% hit to revenues due to currency factors. The only drug to beat analyst forecasts in the quarter was Basaglar – a biosimilar of Sanofi’s Lantus (insulin glargine) – which grew 51% to $251m.
Lilly has other new medicines rolling out to help it manage the Cialis patent cliff, and third-to-market CGRP inhibitor for migraine – Emgality (galcanezumab) – added $14m in the quarter, overtaking second entrant Ajovy (fremanezumab) from Teva, according to Lilly, but still well behind Amgen’s first-to-market Aimovig (erenumab).
Lilly’s head of bio-medicines Christi Shaw said on a conference call that Emgality will overtake Aimovig in the second quarter in terms of total prescription volumes. She also acknowledged that Taltz will face increasing competition now that Skyrizi is available, but said Lilly’s drug clinical profile -and particularly tolerability – would keep growth strong in an expanding market.
Overall, Lilly is predicting sales of $22bn-$22.5bn for 2019 as a whole, down on its earlier estimate of $25.1bn to $25.6bn. A big chunk of that difference stems from its spinoff of animal health business Elanco however.