The Friday Five – Five of the past week's pharma stories you can't afford to ignore...

Price before efficacy in US diabetes market?

The sales and marketing battle in the US diabetes market has been a frequent topic of analysis on FirstWord in recent weeks. Further evidence of its importance was provided on Tuesday when Novo Nordisk confirmed that contracts to supply its GLP-1 agonist Victoza and insulin brands NovoLog and Novolin to the pharmacy group Express Scripts will expire at the end of the year.

The decision by Express Scripts to replace the NovoLog and Novolin brands with competing insulins from Eli Lilly came with muted surprise; both companies have previously competed on pricing in the insulin market. However, the decision to replace Victoza – widely perceived to be the best-in-class product – with Bristol-Myers Squibb's Byetta/Bydureon caught analysts off-guard - for further analysis see ViewPoints: As Novo Nordisk finds to its loss, price is now king in the US diabetes market.

see also Spotlight On: Diabetes marketing battle heats up as hostilities intensify and Physician Views Poll Results – Novo Nordisk winning the US diabetes marketing battle.

Outcomes study results provide no respite for DPP-4 inhibitor class

Although the Express Scripts contract may provide some impetus for flagging sales of Byetta/Bydureon, Bristol-Myers Squibb's other key diabetes franchise Onglyza reportedly remains under pressure. Full data from the SAVOR and EXAMINE studies – long-term outcomes studies for Onglyza and the competing DPP-4 inhibitor Nesina (marketed by Takeda) – released earlier this week demonstrated no cardiovascular benefit for either product, thus removing one potential catalyst that could have potentially offset "reimbursement and utilisation pressure" on the DPP-4 class, noted analysts - see ViewPoints: Will lack of cardiovascular benefit weigh on DPP-4 class and provide other diabetes drug classes with additional momentum?

Post-deal details from Amgen/Onyx

More details emerged this week about Amgen's recently announced offer to acquire Onyx Pharmaceuticals, including the news that Onyx CEO Tony Coles will pocket $58 million from the transaction.

Given his role in transforming Onyx over the past few years, there is likely to be significant speculation as to where Coles will end up next (and if he does 'lose' his job at Amgen/Onyx, he will reportedly receive a further $3.4 million in severance pay). His legacy at Onyx is almost certain to be centred on the deal to acquire Proteolix for an upfront payment of $276 million. That deal provided Onyx with the potential $3-billion-a-year cancer franchise Kyprolis, which in turn attracted Amgen to pay $10.5 billion to acquire Onyx.

Suggestions that Amgen may have made some unorthodox moves to help the negotiating process with Onyx also emerged this week. According to the smaller company, Amgen had asked to see fully unblinded results from an interim analysis of the ongoing Kyprolis FOCUS study. Given the difficulties that Onyx would have faced if it had revealed this data (it didn't), Amgen must have known that a positive response was always unlikely, suggested International Strategy & Investment analyst Mark Schoenebaum in a note to investors. He adds, however, that Amgen probably perceived the issue as a way to pressure Onyx on price. Did it work? – perhaps; at just $125 per share, Amgen's accepted bid for Onyx was just $5 per share higher than its opening gambit.

Hope for an Eliquis turnaround?

This week's FirstWord Physician Views poll was conducted among 327 cardiologists based in the 5EU markets and sought to gain an insight into how new oral anticoagulants are being utilised in the region. Bristol-Myers Squibb and Pfizer's Eliquis – which has so far delivered a slower than expected commercial performance, despite its perceived best-in-class profile – remains the third most popular product (behind Bayer and Johnson & Johnson's Xarelto and Boehringer Ingelheim's Pradaxa) but there is scope for encouragement. A sizeable proportion of respondents cited it as their preferred treatment, with Eliquis' clinical profile appearing to gain more traction among physicians. FirstWord Pharma PLUS users can see the results of the poll here.

Each of the three available oral anticoagulants will be looking to establish their positions in the market prior to the launch of Daiichi Sankyo's Lixiana, for which robust Phase III data was released earlier this week - see ViewPoints: The oral anticoagulant market – will three become four and what threat does Daiichi’s Lixiana pose to Bayer/Johnson & Johnson’s Xarelto?

GlaxoSmithKline allegations intensify – has China looked hard enough domestically in corruption probe, ask EU authorities

Ongoing investigations into the marketing practices of GlaxoSmithKline appeared to take a negative turn this week when it was alleged that the bribery of doctors was coordinated by the company and not individuals. It is suggested that high sales growth targets set by GlaxoSmithKline executives – at some 7 to 8 percentage points above average levels of market growth – are a root cause for the alleged practices that the drugmaker has said are a "clear breach of our corporate values."

With regard to the ongoing investigation, those growth targets are not the only high numbers being thrown around, with suggestions on Wednesday that the Chinese government is considering whether to implement large fines against the UK drugmaker.

The European Union Commerce of Chamber suggested on Thursday that foreign pharmaceutical companies had been unfairly targeted by Chinese authorities, highlighting the fact that no domestic players appear to have fallen foul as part of the recent investigations.

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