An article claiming that Sanofi-Aventis’ (SNY) Multaq received a lukewarm reception from a committee that helps set reimbursement rates for new drugs in France appeared to rattle investors; shares in the company were notably weaker Monday than its other big pharma peers, a sector admittedly jumpy in the wake of US healthcare reform news.
The label “future blockbuster” has long been pinned to Multaq and many financial analysts are very optimistic about its commercial potential; according to EvaluatePharma consensus for sales in 2014 currently sits at a portly €1.54bn ($2.18bn). As such an important growth driver, its launch progress is being closely watched and unfortunately this rumbling from France is not the first discouraging signal to emerge. It is still very early days in the launch of the atrial fibrillation treatment but with expectations so high, investors are right to feel nervous.
Little extra
According to a report in French newspaper La Tribune, the review was conducted by a panel of doctors and health specialists called the transparency committee, which advises the government’s economic committee of health products on the level of state reimbursement that new drugs should receive.
The transparency committee judged that Multaq contributed little over existing medicines, implying a low reimbursement rate could be on the cards with obvious implications for demand.
Earlier this year, the UK’s closely-watched drug reimbursement body, the National Institute of Clinical Excellence (NICE), also refused to recommend the use of Multaq on the National Health Service. The agency decided that Multaq was no more beneficial than standard, generic therapies and because it is much more expensive, it is not cost effective.
It remains to be seen whether France eventually takes an equally dim view of the medicine, but it appears that Multaq could well have a steep hill to climb throughout Europe.
Slow take up
In the US the drug has been on the market since July and Sanofi has only reported two quarters of sales for the product, €13m in the third quarter and €12m for the fourth quarter.
Not all analysts have been impressed by these figures - for example Cowen & Co was anticipating sales of €37m in the fourth quarter. Prescription numbers are also being scrutinized and there are certainly signs that demand is growing, with the drug taking a 6.6% share of the anti-arrhythmia market in January, according to some analyst reports.
Still, some are unimpressed with this trajectory. Jefferies noted recently that the take up has been slow compared to benchmark drugs Januvia and Tekturna, although the bank has a much more pessimistic view of the product than others, with a peak sales estimate of just $300m.
Although most analysts are more optimistic than this, there is still a fairly big range of forecasts making up consensus. For example, Morgan Stanley has pencilled in sales of €2.50bn by 2014, whilst Nomura is only anticipating €739m. And despite a slower US launch than some were expecting, consensus for 2014 has almost doubled since the drug hit the market in July, to €1.54bn.
What the future holds
With the US launch now in full swing and the first sales figures from Europe set to emerge next month, what 2010 holds for Multaq will be hugely influential on whether these numbers further out start to shift. This year, consensus sits at €290, which implies €72.5m per quarter.
Shares in Sanofi recovered in later trading Monday, having fallen almost 3% earlier to touch €55.10, however the issue is only likely to gain greater focus as the launch progresses. Sanofi will report first quarter results on April 29, and Multaq will be a key issue.
The drug has a lot of ground to make up if it is to meet this year’s expectations, let alone the lofty figures set for five years' time.
