Amgen's Competition Against Its Top Products: A Comprehensive Look For 2017-2018

| About: Amgen Inc. (AMGN)

Summary

Amgen will likely keep two billion-dollar-per-quarter sellers for 2017 and 2018.

The number of company blockbusters remain at 8 next year, losing Neupogen but gaining Kyprolis.

There should be overall growth, and XGEVA may be the sleeper hit of the bunch.

Amgen, Inc. (AMGN) is one of the largest biotechnology companies, with a market cap of $108.2 billion and a diverse portfolio. On October 27, Amgen reported third quarter 2016 financial results. Amgen's Q3 revenues totaled $5.52 billion, which is flat year over year. The listed brands accounted for 97.7% of sales (Table 1). A previous article saw encouraging insurance coverage for Amgen's newer offerings, but of these, only Repatha has cracked the top 12.

Because of Amgen's reliance on its best-performing drugs, investors should be aware of rival companies and brands (Table 2). Amgen will also face increasing competition from biosimilars or generics, but as long as lead product Enbrel doesn't decrease by more than 4% YOY (around $50-60 million per quarter), growth from its other entries such as XGEVA and KYPROLIS may compensate. On the other hand, Enbrel is not likely to decline much next year due to the recent approval of its supplemental Biologics License Application (sBLA).

Table 1. Amgen Global Product Sales, 2016

$Millions

(except %)

Q3'16

QOQ Δ

YOY Δ

Q2'16

QOQ Δ

YOY Δ

Q1'16

QOQ Δ

YOY Δ

US

ROW

TOTAL

TOTAL

TOTAL

US

ROW

TOTAL

TOTAL

TOTAL

US

ROW

TOTAL

TOTAL

TOTAL

Enbrel®

1,388

64

1,452

-2%

0%

1,423

61

1,484

7%

10%

1,326

59

1,385

-4%

24%

Neulasta®

1,024

176

1,200

4%

-5%

962

187

1,149

-3%

-1%

996

187

1,183

2%

4%

Aranesp®

275

256

531

5%

8%

260

244

504

-5%

5%

261

271

532

7%

11%

Sensipar®/ Mimpara®

329

86

415

7%

18%

303

86

389

6%

13%

278

89

367

-4%

10%

XGEVA®

296

98

394

3%

4%

275

106

381

1%

15%

271

107

378

6%

11%

Prolia®

249

130

379

-14%

18%

286

155

441

25%

30%

221

131

352

-7%

29%

EPOGEN®

335

0

335

1%

-31%

331

0

331

10%

-33%

300

0

300

-12%

-44%

KYPROLIS®

140

43

183

6%

34%

142

30

172

12%

45%

129

25

154

4%

43%

NEUPOGEN®

127

56

183

-7%

-36%

141

55

196

-8%

-23%

150

63

213

-19%

-13%

Vectibix®

64

100

164

2%

24%

52

108

160

11%

0%

56

88

144

7%

18%

Nplate®

92

59

151

6%

10%

84

58

142

1%

14%

86

55

141

3%

12%

Repatha®

31

9

40

48%

*

20

7

27

69%

*

14

2

16

*

*

BLINCYTO®

19

10

29

-3%

26%

21

9

30

11%

76%

21

6

27

*

80%

Other**

14

46

60

-12%

46%

17

51

68

45%

19%

10

37

47

*

0%

Total

4,383

1,133

5,516

1%

0%

4,317

1,157

5,474

4%

5%

4,119

1,120

5,239

-2%

7%

Click to enlarge

* Not meaningful

** Other includes MN Pharma, Bergamo, IMLYGIC® and Corlanor®

Table 2. Amgen's Significant Competitors

Product

Territory

Competitor Product

Competitors

Enbrel®

U.S. & Canada

REMICADE®

Johnson & Johnson (NYSE:JNJ)/Merck (NYSE:MRK)

U.S. & Canada

HUMIRA®

AbbVie (NYSE:ABBV)

U.S. & Canada

ORENCIA®

Bristol-Myers Squibb (NYSE:BMY)

U.S. & Canada

CIMZIA®

UCB (OTCPK:UCBJF)

U.S. & Canada

SIMPONI®

JNJ

U.S. & Canada

STELARA®

JNJ

U.S. & Canada

Otezla®

Celgene (NASDAQ:CELG)

U.S. & Canada

Cosentyx™

Novartis (NYSE:NVS)

Neulasta®

Europe

Lonquex® (biosimilar)

Teva Pharmaceutical Industries (NASDAQ:TEVA)

Europe

Filgrastim biosimilars

Various

XGEVA®

U.S. & Europe

Zoledronate generics

Various

Prolia®

U.S. & Europe

Alendronate generics

Various

U.S. & Europe

Raloxifene generics

Various

U.S. & Europe

Zoledronate generics

Various

Aranesp®

U.S.

PROCRIT®

JNJ (licensee)

Europe

EPREX®/ERYPO®

JNJ

Europe

Epoetin alfa biosimilars

Various

U.S. & Europe

MIRCERA®

Galenica Holding (OTC:GNHAY)/ Roche (OTCQX:RHHBY)

EPOGEN®

U.S.

MIRCERA®

Galenica

Sensipar®/Mimpara®

U.S. & Europe

Active Vitamin D analogs

Various

NEUPOGEN®

U.S.

Granix®

Teva

U.S.

Zarxio™

Novartis

U.S. & Europe

Leukine®

Sanofi (NYSE:SNY)

Europe

Filgrastim biosimilars

Various

Vectibix®

U.S. & Europe

Erbitux®

Eli Lilly (NYSE:LLY)/BMY; Merck

U.S. & Europe

Avastin®

Roche

Nplate®

U.S. & Europe

Promacta®/Revolade®

Novartis

Kyprolis®

U.S.

VELCADE®

Takeda Pharmaceutical Company (OTCPK:TKPYY)

U.S.

REVLIMID®

Celgene

U.S.

POMALYST®

Celgene

U.S.

DARZALEX™

JNJ

U.S.

FARYDAK®

Novartis

Click to enlarge

Enbrel

Enbrel, one of the anti-tumor necrosis factor alpha (TNF-α) granddaddies, is covered in some form by each of the top health insurance companies in the US (Table 3), and so will likely retain its market share for a few more years. Enbrel (given weekly) remains the gold standard for effectiveness in rheumatoid arthritis, which has helped it withstand challengers administered monthly (CIMZIA, Simponi) or every 8 weeks (REMICADE, Simponi Aria).

Shockingly, efficacy or convenience isn't always enough, and sometimes it comes down to who can make better contract negotiations with insurance companies. In the dermatology segment, Cosentyx is superior to Enbrel and Stelara in clearing psoriasis skin, but can't crack the formularies of the nation's two major pharmacy benefit managers (PBMs), Express Scripts (NASDAQ:ESRX) Medicare or CVS Caremark (NYSE:CVS). The only oral entry, Otezla, has similarly not made headway either.

Table 3. Tumor Necrosis Factor α Inhibitors and Competing Therapies, US Insurance Coverage

HEALTH INSURERS

Enbrel

REMICADE

HUMIRA

ORENCIA

CIMZIA

SIMPONI

STELARA

Otezla

Cosentyx

MEDICARE/GOVERNMENT

CVS/Caremark

$$$

$$$

$$$

Express Scripts

$$$ PA

$$$ PA

$$$ PA

$$$ PA

UnitedHealthcare

$$$ PA,ST

$ PA

$$$ PA,ST

$ PA

$ PA

$ PA

$$$ PA,ST

$$$ PA,ST

TRICARE

$$

$$$ PA

$$

$$$ PA, ST

$$$ PA, ST

$$$ PA, ST

$$$ PA, ST

Kaiser Permanente

$$$

$$$

$$$

$$$

$$$

$$$

$$$ PA

$$$ PA

$$$

Anthem Blue Cross and Blue Shield (BCBS)

$$$

$$$

$$$

$$$

$$$

$$$

Aetna Medicare

$$$ PA

$$$ PA

$$$ PA

Humana

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

Humana Medicaid

$$ PA

$$ PA

$$ PA

$$ PA

$$ PA

BCBS Illinois

$$$

$$$

$$$

$$$

$$$

BCBS Montana

$$$

$$$

$$$

$$$

BCBS NM, OK, TX

$$$

$$$

$$$

$$$

BCBS NM Medicaid

$ PA

$ PA

$ PA

BCBS IL Medicaid

$

$

$

$

$

BCBS TX Medicaid

$

$

$ PA

$ PA

$ PA

$ PA

$ PA

Highmark

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

Cigna HealthCare

$ PA

$ PA

$ PA

Blue Shield of California

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

Independence Blue Cross

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

HEALTH EXCHANGES

Kaiser Permanente (CA)

$$$

$$$

$$$

$$$

(X)

$$$

$$$

Anthem BCBS (OK)

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

Aetna

$ PA

$$ PA

$ PA

$$$ PA,ST

$$$ PA,ST

$$$ PA

$ PA

$$$ PA,ST

$$$ PA,ST

Humana

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

BCBS IL, MT, OK

$$$

$$$

$$$

$$$

$$$

$$$

$$$

BCBS Texas

$

$

$$

$

$

$$

$$

Cigna HealthCare (TX)

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

Highmark

$$ PA

$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

Blue Shield of California

$$ PA

$$ PA

$$ PA,SP

Independence Blue Cross (PA)

$$ PA

$ PA

$$ PA

$ PA

$$ PA

$$ PA

$$ PA

OTHER PRIVATE

CVS/Caremark

$$$ PA

$$$ PA

Express Scripts

$$$

$

$

X

X

$

$

$

UnitedHealthcare

$$$ PA,ST

$ PA

$$$ PA,ST

$ PA

$ PA

$ PA

$$$ PA,ST

$$$ PA,ST

Kaiser Permanente

$$$

$$$

$$$

$$$

X

X

$$$

$$$

Anthem BCBS

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

Aetna Individual

$ PA

$$ PA

$ PA

$$$ PA,ST

$$$ PA,ST

$$$ PA

$ PA

Humana

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

BCBS Illinois

$$$

$$$

BCBS MT, OK, TX

$$$

$$$

$$$

$$$

Cigna HealthCare

$$$ PA

$$$ PA,ST

$$$ PA

$$$ PA,ST

$$$ PA,ST

Highmark

$$ PA

$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

Blue Shield of California

$$ PA

$$ PA

$$ PA,SP

Independence Blue Cross

$$ PA

$ PA

$$ PA

$ PA

$$ PA

$$ PA

$$ PA

Click to enlarge

Legend:

$ = Preferred brand (Lowest copay, sometimes referred to as Tier 2)

$$ = Non-preferred brand

$$$ = Highest tier / Specialty

BLANK / X (excluded this year) = Not listed / Non-formulary / Not covered

( ) = May be covered at highest tier after medical review

PA = Prior Authorization required

ST = Step Therapy required (patient has to try other treatments first)

Click to enlarge

Cosentyx and Otezla also had expanded indications over the past year (bold in Table 4). Lilly's Taltz, approved in March by the Food and Drug Administration (FDA) for adults with moderate-to-severe plaque psoriasis, has already been included by CVS for 2017 and may become a major player. Despite the increased competition, Enbrel will be buoyed after the FDA designated it earlier this month as the first and only systemic therapy to treat pediatric patients (ages 4-17) with chronic moderate-to-severe plaque psoriasis.

Table 4. Tumor Necrosis Factor α Inhibitors and Competing Therapies, U.S. Approved Indications in Adults

Approved by the FDA

Ankylosing Spondylitis

Plaque Psoriasis

Psoriatic Arthritis

Rheumatoid Arthritis

Juvenile Idiopathic Arthritis

Enbrel

11/2/1998

Remicade

8/24/1998

Humira

12/31/2002

Orencia

12/23/2005

Cimzia

4/22/2008

Simponi

4/24/2009

Stelara

9/25/2009

Otezla

3/21/2014

Cosentyx

1/21/2015

Click to enlarge

Neulasta/NEUPOGEN

Amgen's NEUPOGEN patients have largely been converted to Neulasta. Unlike Zarxio, Granix technically isn't a biosimilar to NEUPOGEN since the FDA hadn't established a biosimilars approval pathway at the time of Teva's BLA submission, but nothing prevents doctors and payors from treating Granix as such. The American Society of Clinical Oncology (ASCO) recommendations for the administration of hematopoietic colony-stimulating factors (CSFs) are summarized in Table 5.

Note that ASCO didn't support the use of Granix beyond its lone approved indication of reducing the duration of severe neutropenia in patients with nonmyeloid malignancies receiving myelosuppressive anticancer drugs associated with a clinically significant incidence of febrile neutropenia (FN); ASCO limited Leukine in the same way.

Table 5. Dosing and Administration of White Blood Cell Growth Factors

NEUPOGEN

In adults, recommended dose is 5 μg/kg per day for all clinical settings other than peripheral-blood progenitor cell (PBPC or stem cell) mobilization; in setting of PBPC mobilization, dose of 10 μg/kg per day may be preferable

Zarxio

Same as for NEUPOGEN

Granix

Granix should be after administration of myelotoxic chemotherapy; in adults, recommended dose is 5 μg/kg per day. [NCCN recommends 10 μg/kg per day in setting of PBPC mobilization]

Neulasta

6 mg should be administered once 1 to 3 days after chemotherapy if possible; because some patients will not be able to return for dose of Neulasta because of distance or immobility, for instance, alternatives to consider may include self-administered NEUPOGEN or Granix or same-day Neulasta, recognizing that although same-day Neulasta is not as effective as later Neulasta, it is better than no Neulasta; Neulasta is also available in a timed automated-inject device that delivers 6 mg subcutaneously, 27 hours after it is placed on skin and activated; Neulasta is not currently indicated for stem-cell mobilization; 6-mg formulation should not be used in infants, children, or small adolescents who weigh < 45 kg

Leukine

Because Leukine has been licensed specifically for use in mobilization and after transplantation of autologous PBPCs, after autologous or allogeneic bone marrow transplantation, and for acute myeloid leukemia, manufacturer's instructions for administration are limited to those clinical settings; recommended dose for adults is 250 μg/m 2 per day

Click to enlarge

This year, the National Comprehensive Cancer Network (NCCN) also no longer recommends Leukine for the prophylactic treatment of FN. Since neither body has no restrictions on which CSF to use for FN, prescriber choice likely comes down to convenience and cost. Novartis does make it easier than Teva for patients, with its Sandoz One Source program that grants $10 co-pays for Zarxio prescriptions after the free first one. In Amgen's FIRST STEP Program, patients pay $25 for subsequent cycles. For health plans, the me-too drugs are cheaper (based on list price alone) than NEUPOGEN by 11% (Granix) and 15% (Zarxio), but the differences are not too steep for Amgen to negotiate around.

Of course, the long-acting and more convenient Neulasta is priced at a premium. About half of patients on chemo regimens with a high risk of FN are treated with CSF for 4-5 days, so insurers can realize savings with NEUPOGEN amounting to $3400-4900 per cycle, depending on the member's weight. However, providers have to weigh the increased risk of hospitalization with shorter courses of short-acting CSFs, along with the improved compliance and theoretically corresponding greater efficacy with a one-dose Neulasta and its handy Onpro kit.

A very recent study on 2005-2013 claims data from two large healthcare claims repositories (Truven Health Analytics and IMS) found that 8.6% of FN that resulted in hospitalization occurred when Neulasta was administered the day same as chemo, which is inconsistent with already established guidelines, while 41% of FN hospitalization were in patients who DID NOT receive CSF prophylaxis, showing underutilization.

Novartis declared that Zarxio has had a good start and scraped up more than $100 million since launch. In the same period (Q4 2015 to Q3 2016), NEUPOGEN's US sales were $621 million, compared to $787 million the previous 12 months. In contrast, Teva's claim that as of February 2016 Granix "gained 41% share of the US short-acting G-CSF hospital market in its first 27 months" (Figure 1) is meaningless. NEUPOGEN's 2015 US revenues were $793 million compared to $839 million (-5% YOY) in 2014. Granix doesn't appear in Teva's 2015 report (Nuvigil was the lowest earner mentioned at $373 million; Azilect earned $80 million in Q4).

Figure 1. Teva Pharmaceutical Industries: Trusted to take a bite out of G-CSF acquisition costs?

To conclude this section, NEUPOGEN held off Granix but is more susceptible to Zarxio and will continue to bleed, although probably remaining in the $100 million's. Neulasta will likely stay at the $1.0-1.2 billion range for the next several quarters, as the further adoption of Onpro helps prescribers adhere to guidelines, which also mitigates the biosimilar competition.

Prolia/XGEVA (Denosumab)

Since August, a couple of data readouts will help spur denosumab above its rivals and sustain growth into 2017 and beyond. First, Prolia, compared to the risedronate, led to significantly greater gains in bone mineral density (BMD) at the lumbar spine and total hip, both in patients newly initiating or continuing glucocorticoid therapy (7.5 mg or greater daily prednisone or its equivalent, which is the threshold for intervention by the American College of Rheumatology [ACR]). Bisphosphonates, such as risedronate and zoledronic acid (ZA), are recommended by ACR guidelines, but Prolia is currently not. A 2017 ACR update for glucocorticoid-induced osteoporosis is currently under peer review and will likely include Prolia as an option.

Second, a Phase 3 event-driven study demonstrated non-inferiority of XGEVA compared with standard of care ZA for the prevention of skeletal-related events (SREs) in patients with newly diagnosed multiple myeloma. These results should garner XGEVA an expanded label in multiple myeloma and could make it the preferred agent in patients with mild renal impairment (creatinine clearance [CrCl] <60 mL/min), since ZA needs a dosage adjustment.

Aranesp/EPOGEN

Similar to what happened with the myeloid growth factors, the cannibalization between Amgen's erythropoiesis-stimulating agents (ESAs). EPOGEN's dialysis customer base built up Aranesp. And although Amgen dodged a bullet when a short-acting biosimilar (to EPOGEN) entrant was delayed by more than a year, a relaunched MIRCERA has proven to be formidable. In May 2015, Galenica secured twin deals with an exclusive license agreement with Roche to sell MIRCERA in the US and Puerto Rico, as well as to supply Fresenius Medical Care (NYSE:FMS) North American dialysis facilities.

Since Galenica took over MIRCERA, they have generated $360 million ($1 has historically been roughly equal 1 Swiss Franc), without help from the top PBMs and health plans(Table 6). During the same time frame (Q2 2015 to Q2 Q2016), Amgen's ESA pair raked in $3.185 billion in US sales, compared to $3.548 billion in the previous 5-quarter period.

In contrast, Johnson & Johnson's PROCRIT tallied $942 million and $878 million in the US for those respective quarters, which was assisted by great tier placement from payors; it was the sole ESA on both CVS and Express Scripts. PROCRIT's performance would imply unhindered growth; however, Q3 sales were only $168 million, its lowest since Q1 2015.

Table 6. Erythropoiesis-Stimulating Agents, US Insurance Coverage

HEALTH INSURERS

Aranesp

PROCRIT

MIRCERA

EPOGEN

MEDICARE/GOVERNMENT

CVS/Caremark

$

Express Scripts

$$$ PA

UnitedHealthcare

$

$

$

TRICARE

$$$

$$$

$

$$$

Kaiser Permanente

$$ PA

$ PA

$$ PA

$ PA

Anthem Blue Cross and Blue Shield

$$

$$

Aetna Medicare

$ PA

$$$ PA

Humana Medicare/Medicaid

$$ PA

$$ PA

BCBS IL, NM, OK, TX

$$

$$

BCBS Montana

$$

$$

$$

BCBS NM Medicaid

$ PA

BCBS IL Medicaid

$

$

$

BCBS TX Medicaid

$

$

Highmark

$ PA

$ PA

$$ PA

$ PA

Cigna HealthCare

$ PA

$ PA

Blue Shield of California

$$$ PA

$$$ PA

$$ PA

Independence Blue Cross

$$ PA

$ PA

$$ PA

HEALTH EXCHANGES

Kaiser Permanente (CA)

$

Anthem BCBS (OK)

$$$ PA

$$$ PA

Aetna

$$ PA

$$ PA

$$$ PA

$$$ PA

Humana

$$$ PA

$$$ PA

BCBS IL, MT, OK

$$$

$$$

$$

$$$

BCBS Texas

$$

$

$$

$$

Cigna HealthCare (TX)

$$$ PA

$$$ PA

Highmark

$$ SP

$$ SP

$$ SP

Blue Shield of California

$$ PA

Independence Blue Cross (PA)

$$

$

$$

OTHER PRIVATE

Express Scripts

X

$$$

X

X

UnitedHealthcare

$

$

$

Anthem BCBS

$$$ PA

$$$ PA

$$$ PA

$$$ PA

Aetna

$$ PA

$$ PA

$$$ PA

Humana

$$$ PA

$$$ PA

$$$ PA

BCBS IL, MT, OK, TX

$$$

$$$

$$$

Cigna HealthCare

$ PA

$ PA

Highmark

$$ SP

$$ SP

$$ SP

Blue Shield of California

$$ PA

Independence Blue Cross

$$

$

$$

Click to enlarge

Coincidentally, Galenica also got its hands on the proposed biosimilar. The FDA had delivered a complete response letter to Pfizer's Retacrit BLA in October 2015. Galenica licensed US rights for Retacrit last May; however, there has been no news on a BLA resubmission. Thus, EPOGEN and Aranesp will likely retain the top two spots in the American ESA market next year.

The Rest

There have been no major changes in the spaces occupied by Sensipar (Mimpara in Europe), Nplate, and Vectibix since the 2015 version of this article. These brands will likely contribute solid but unspectacular growth in 2017. The last, but not least, member of this group has the best chance of joining the blockbuster cast next year. Though it still lags in the number of formulary wins (Table 7), KYPROLIS has been climbing in stature in the dynamic market of multiple myeloma, as evidenced by recent changes in the NCCN guidelines.

The KYPROLIS/REVLIMID/dexamethasone (KRd) triplet is an option in first line treatment, but is one of the preferred regimens in previously-treatment patients. The KYPROLIS/ dexamethasone doublet is another newly preferred second-line regimen. With more data, KRd may become a preferred frontline therapy and eventually supplant the triplet of VELCADE/REVLIMID/ dexamethasone. VELCADE is in the same class as KYPROLIS, but causes peripheral neuropathy.

Table 7. Multiple MyelomaTherapies, US Insurance Coverage

Kyprolis

VELCADE

REVLIMID

POMALYST

DARZALEX

FARYDAK

HEALTH INSURERS

MEDICARE/GOVERNMENT

CVS/Caremark

$$$

$$$

$$$

$$$

Express Scripts

$$$

$$$ PA

$$$

$$$ PA

UnitedHealthcare

$ PA

$$ PA

$$ PA

TRICARE

$

$

$

Kaiser Permanente

$$$

$

$$$

$$$

$$$

$$$

Anthem Blue Cross and Blue Shield

$$$

$$$

$$$

$$$

$$$

Aetna Medicare

$$$ PA

$$$ PA

$$$ PA

$$$ PA

Humana

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

Humana Medicaid

$$ PA

$$ PA

$$ PA

$$ PA

$$ PA

BCBS IL, MT, NM, OK, TX

$$$

$$$

$$$

$$$

$$$

BCBS NM Medicaid

$ PA

$ PA

$ PA

BCBS IL Medicaid

$

$

$

$

$

BCBS TX Medicaid

$

$

$

Highmark

$$$

$$$ PA

$$$ PA

$$$ PA

$$$ PA

Cigna HealthCare

$ PA

$ PA

$ PA

$ PA

$ PA

Blue Shield of California

$$$

$$$ PA

$$$ PA

$$$ PA

$$$ PA

Independence Blue Cross

$$$ PA

$$$ PA

$$$ PA

$$$ PA

$$$ PA

HEALTH EXCHANGES

Kaiser Permanente (CA)

(X)

$$$

$

$$$

(X)

X

Anthem BCBS (OK)

$$$ PA

$$$

Aetna

$$$ PA

$$$ PA

$$$ PA

Humana

$$$ PA

$$$ PA

$$$ PA

BCBS IL, MT, OK

$$$

$$$

$$$

BCBS Texas

$$$

$$$

$$$

Cigna HealthCare

$$$ PA

Highmark

$$ PA

$$$ PA

$$$ PA

Blue Shield of California

$$ PA

Independence Blue Cross (PA)

$$ PA

$$ PA

$$ PA

OTHER PRIVATE

CVS/Caremark

$$$ PA

$$$ PA

$$$ PA

UnitedHealthcare

$ PA

Kaiser Permanente

$$$

$$$

$

$$$

$$$

$$$

Anthem BCBS

$$$ PA

$$$ PA

$$ PA

$$$ PA

$$$ PA

$$$ PA

Aetna

$$$ PA

$$$ PA

$$$ PA

Humana

$$$ PA

$$$ PA

$$$ PA

BCBS IL, MT, OK, TX

$$$

Cigna HealthCare

$$$ PA

$$$ PA

$$$

Highmark

$$ PA

$$$ PA

$$$ PA

Blue Shield of California

$$ PA

Independence Blue Cross (PA)

$$ PA

$$ PA

$$ PA

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Several of the same conclusions from last year still apply: Many threats abound for Amgen's current products, including a new FDA-approved biosimilar to Enbrel. Enbrel and Neulasta should still be collecting $1 billion/quarter until 2018. The Prolia/XGEVA pair will likely be more profitable than the ESAs moving forward as EPOGEN loses market share. Without going into too much depth, Wall Street's revenue forecast of $23.51 billion for 2017 seems fair.

Disclosure: I am/we are long AMGN.

I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it (other than from Seeking Alpha). I have no business relationship with any company whose stock is mentioned in this article.