April Fool's Day in 2022 was a joke with China's first marketed PD-1.
On April 1, Junshi Bio issued an announcement that its PD-1 Terepliumab (Tuoyi) annual sales revenue was 412 million yuan, compared with 1.003 billion yuan in 2020, and sales fell by about 60% year-on-year.
I still remember the 2020 medical insurance negotiation site, when Xiong Jun, chairman of Junshi Biological, reported 906.08 yuan, the medical insurance negotiation expert on the opposite side teased "It's almost the New Year, figure an auspicious number." At that moment, triprimumab set a record for the lowest unit price of PD-1 in China at that time
According to the explanation of Junshi Biology, after the implementation of the national medical insurance catalogue in 2020, the unit price of Junshi's PD-1 decreased by more than 60%, and the company compensated the gap in the inventory of dealers; at the same time, the domestic PD-1 competition was fierce, and Junshi failed to achieve "price for volume", resulting in negative growth in sales revenue.
However, low prices are definitely not the only reason. After all, several domestic PD-1s have been greatly bargained, and after the price is reduced, the actual annual treatment cost of Junshi is not the lowest. The board, whose sales have dropped by 60%, cannot hit the "soul bargaining".
In the past year or so, Three sales executives of Junshi Bio, Duan Xin, Qian Wei and Chu Nan, have left their jobs one after another; the PD-1 grassroots market entrusted to AstraZeneca was hastily recovered at the end of the year.
All this shows that there is a problem with the sales system of Junshi Bio.
Sales grew by just 17 percent, and sales executives left one after another
After being included in medical insurance, Junshi's PD-1 dosage is actually very limited, and it does not reflect the value of medical insurance at all.
In 2020, when Junshi PD-1 did not enter the medical insurance, the sales volume increased by 51.6% year-on-year. By 2021, with medical insurance, the year-on-year growth has shrunk to 17.53%. Analysts pointed out that the growth rate of 17% is not enough to catch up with the market performance of ordinary drugs.
The decline began to show from February 2021. At that time, Junshi reached an agreement with AstraZeneca to license the PD-1 primary market development rights and all market rights and interests in urinary intestinal carcinoma indications to AstraZeneca.
It is easy to understand that the grass-roots market is handed over to AstraZeneca, after all, the county ability of the other party is unique in the whole industry; even the rights and interests of urinary intestinal carcinoma indications are also handed over, which is puzzling.
In the 2020 price negotiations, junshi biotripremumab has only 1 approved indication, namely melanoma. At the beginning of the design of the indications, junshi's strategy for this PD-1 was: "cut from the small indications, and then turn to the large indications", avoiding the head-on confrontation of the mainstream large-variety market.
Therefore, in the price negotiation in 2019, Junshi did not firmly reduce the price, nor did it negotiate, perhaps because there are too few indications, the price reduction can not be exchanged for sales.
By 2020, the situation in the PD-1 field has turned around. This time, although there is still only one melanoma indication, Junshi PD-1 also had to be forced to reduce the price into medical insurance.
However, for the indications for urinary tract carcinoma, Junshi has always paid more attention. The data disclosed by the company shows that in this indication, triprimumab and other PD-1 ratios have significant advantages.
Why not believe in your own sales ability and give up the sales rights of an advantageous variety to others?
Public information shows that in the 15 months since 2021, Duan Xin, Qian Wei and Chu Nan, three Junshi executives responsible for the commercialization of PD-1, have left their jobs one after another. People who have been engaged in pharmaceutical sales for a long time told the Health Bureau: These three people are mature executives who have served multinational pharmaceutical companies for a long time, and they have no problem from the perspective of personal ability. Leaving one after another in a short period of time may be a conflict of management concepts.
On November 2, 2021, Junshi disclosed that the new co-CEO Li Cong joined the company, finally giving a temporary answer to the PD-1 sales dilemma. Junshi believes that Li Cong "completed the formation and recovery of the marketing regional team and supplemented the core market personnel".
In the 2021 annual report, Junshi also made a military order -
At present, the sales team is confident of achieving more than 50% of the "new disease" market share in several tumor areas that have been included in the national medical insurance catalogue indications.
The market pattern is initially determined, and small indications are waiting for spring
In fact, Caught in such an embarrassing situation, I really don't blame a few sales celebrities.
The development of indications for Junshi PD-1 has not been fast. At present, triprimumab has only been approved for 3 indications, namely melanoma, nasopharyngeal carcinoma and urinary intestinal carcinoma. According to the latest data from the National Cancer Center in 2022, lung cancer, colorectal cancer, stomach cancer, breast cancer, liver cancer, esophageal cancer and other diseases have entered the top ten new cases in China.
Coincidentally, none of the three indications currently approved by Junshi PD-1 are the top ten cancers in China. This means that the number of patients who meet the criteria for clinical use is much smaller than that of other competitors.
In contrast, Baekje PD-1, whose indications cover at least 5 major cancers such as lung cancer and liver cancer, has sales of about 1.621 billion yuan in 2021, an increase of 56% year-on-year; Cinda PD-1 mainly focuses on liver cancer, with sales reaching 2.8 billion yuan in 2020. Even the newly listed Kangfang Biological PD-1, with an indication for lymphoma, sold for 212 million yuan in less than 4 months after listing.
The R&D pot, if it is completely thrown to the sales department, will certainly not be able to move.
Therefore, although Junshi has adjusted the sales team, if the indications are not expanded rapidly, the future commercialization of triprimumab will still face many challenges.
Jun shi knows this. In 2021, junshi bio's PD-1 anti-combination platinum-containing chemotherapy first-line treatment of locally advanced or metastatic esophageal squamous cell carcinoma, as well as advanced non-small cell lung cancer two new indications have been declared to the State Food and Drug Administration; in addition, the first-line treatment of small cell lung cancer, the first-line treatment of liver cancer, and the phase III clinical treatment of liver cancer have been enrolled; and the research on adjuvant/neoadjuvant therapy for gastric cancer, esophageal cancer and lung cancer is underway.
However, some analysts believe that even if the new major indications are approved for listing, the market opportunity is lost, "Nowadays, the market pattern of PD-1 has been initially determined, and the layout of Junshi Bio has been opened by competitors." ”
Fortunately, Junshi still has a glimmer of life. At present, Treplelimab has laid out overseas markets and received OVERSEAS licensing revenue of US$150 million in 2021; in February 2021, Junshi Bio and Coherus signed an exclusive licensing and commercialization agreement to cooperate on the development and commercialization of Treplelimab in the United States and Canada.
In addition, at the beginning of the outbreak of the epidemic in 2020, junshi authorized Eli Lilly Pharmaceuticals to neutralize the new crown antibodies also gained. Eli Lilly neutralizing antibodies sold well in the U.S. epidemic, and Junshi got a good share of the income.
The two concessions brought junshi about 2.229 billion yuan in revenue, accounting for more than 50% of the total revenue of 4.025 billion yuan last year, which is the profit pillar of Junshi in 2021.
Pinch your fingers, this year Junshi still has a joy. At the end of October 2021, the treatment indications for two nasopharyngeal cancers of triprimumab were accepted by the FDA, and the proposed review date is the end of April 2022. Once approved, Junshi PD-1 is expected to be sold in the United States, becoming the only PD-1 in the world to treat nasopharyngeal cancer.
People in the industry generally believe that Junshi Bio will have a great chance to pass the approval, the myth of PD-1 may continue, and the future victory or defeat is still promising.