Twenty years ago, Pfizer Inc. didn’t sell any drugs treating cancer. Now, it sells 17, including four that were approved in the U.S. at the end of last year, more than any other pharmaceutical company.
The new lineup is projected to generate $8.3 billion in sales this year, according to EvaluatePharma. For the first time, Pfizer in 2019 expects oncology products to outsell the heart and other primary-care medicines the company was long known for.
Pfizer is throwing in with other big drug companies trying to expand their footprint in cancer or gain a toehold, even as many startups hunt for new therapies, too. Driving the attraction: new insights about the disease’s biology that have paved the way for discovery of treatments, combined with major commercial potential if those therapies reach the market.
It is a significant transformation for Pfizer, whose sales of pills like Lipitor for high cholesterol, and other drugs for common ailments, powered its rise into one of the world’s biggest drugmakers. Now, the company is seeking a new round of growth by treating cancer.
“At Pfizer, oncology is one of the core components of the organization — going from an almost afterthought,” said Andy Schmeltz, who runs the business.
Drug-company marketers like the category because promoting the therapies to cancer doctors and hospitals requires a smaller sales force than was needed to sell cholesterol and hypertension medicines to the much larger cadre of primary-care physicians.
Cancer-drug sales are projected to reach $138 billion world-wide this year and are growing 11% a year, according to EvaluatePharma. A year’s treatment typically lists for more than $100,000.
“The unmet need as well as the biological advances are still so significant that there’s a lot of room for a lot of people to be successful,” said Emma Walmsley, chief executive of GlaxoSmithKline PLC, in an interview. Glaxo is trying to get back into cancer-drug sales after exiting from the market in 2014.
This month, Bristol-Myers Squibb Co. said it would buy Celgene Corp. in a $74 billion deal uniting two leading cancer-drug sellers, while Eli Lilly & Co. said it would pay $8 billion for Loxo Oncology Inc. and its drug attacking tumors with a specific genetic alteration.
Yet as more drugs come to market, their manufacturers are likely to square off against each other for patients, eating into each other’s sales. Returns could be further squeezed as the drugs target narrower slices of patients.
And high prices risk triggering cost-control efforts from health plans, especially if more of the drugs are used in combination with other expensive medicines.
“One of the big issues societies and health-care systems will face in the future is how do you finance combination therapy in oncology. It’s a big question without an easy answer,” said Christophe Weber, CEO of Takeda Pharmaceutical Co., in an interview.
New York-based Pfizer was selling billions of dollars in Lipitor pills for high cholesterol, Norvasc for hypertension and Viagra for male impotence when executives began building a dedicated cancer-drugs unit in 2008 as part of a search for new revenue to offset looming patent expirations.
The new strategy, company officials say, included hiring leading scientists like Vanderbilt University Medical Center’s Dr. Mace Rothenberg, now Pfizer’s chief medical officer, to build the company’s cancer capabilities. Pfizer also collaborated with prominent cancer experts in academia and worked to speed up drug development.
Pfizer also used deals to acquire promising drugs it could plug into its pipeline or add approved products to the company’s portfolio. Today the company is targeting three of the biggest segments of oncology patients, those with breast, prostate and lung cancer.
In 2006, the company received U.S. approval to sell a cancer drug, called Sutent, for the first time since 1970.
The 2011 approval of lung-cancer drug Xalkori stemmed from Pfizer’s efforts to join with leading cancer experts outside the company. Massachusetts General Hospital researchers helped the company find patients with a specific gene mutation thought to be a good target for the drug.
The ability to zero in on the right patients so quickly wasn’t common at the time, and it enabled investigators to avoid the normal painstaking way of finding appropriate trial subjects.
“You can imagine how hard and slow of a process that would have been,” said Alice Shaw, a Massachusetts General cancer doctor who worked with Pfizer on Xalkori’s development.
Xalkori’s approval gave Pfizer a head start studying patients whose tumors became resistant to the drug, according to company officials and Dr. Shaw. For those patients, the company, still working with the hospital, developed a new lung-cancer treatment called Lorbrena.
The new drug was approved on an accelerated timetable in November based on results from an early-stage trial, a goal of the company as it tries to speed up drug development, according to Chris Boshoff. Dr. Boshoff joined Pfizer from UCL Cancer Institute in 2013 and now oversees the company’s late-stage cancer-drug development.
Five of the last seven Pfizer cancer drugs were approved at an accelerated pace, without a late-stage trial, including Daurismo for acute myeloid leukemia in November.
Pfizer’s top-selling oncology drug, named Ibrance, treats breast cancer, and rang up nearly $3 billion in sales during the first nine months of 2018. The company’s 17 cancer drugs include three less-expensive copies of biotech drugs known as biosimilars.
Despite its success developing cancer drugs, Pfizer has struggled with an important class of treatments called immunotherapies, which unleash a patient’s own immune system on tumors.
Pfizer’s main immunotherapy, Bavencio, developed with Merck KGaA and approved last year to treat two different relatively rare cancers, has failed four late-stage studies for other tumors. The company says it plans to take advantage of the class by pairing its drugs with those from other companies.
