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Roche’s COVID-19 hopeful Actemra soars amid pandemic as Lucentis, Ocrevus falter

At first glance, Roche’s business has been steady during the COVID-19 crisis. But below the surface, executives still warn of volatilities, though not all of them are bad.

For one thing, sales of rheumatoid arthritis drug Actemra jumped 30% to CHF 666 million ($687 million), significantly higher than the 8% increase it posted last year. The med has recently drawn wide interest as a potential treatment to manage potentially deadly immune complications in severe COVID-19 patients.

As soon as word came out of China that Actemra might work in coronavirus-related pneumonia, Roche immediately started ramping up production capacity, including at its dedicated facility at Vacaville, California.

“We’ve got additional production capacity if we need it, but so far we’ve been able to supply everything required, and we’re working on building a stockpile,” Roche’s pharma chief Bill Anderson said on a conference call on Wednesday. He said the trend will continue at least through the second quarter.

Demand will surge further if the current pandemic drags on and if the IL-6 inhibitor proves its use in the clinic. In addition to researchers running their own studies in different parts of the world, Roche itself recently launched a randomized, placebo-controlled clinical trial of Actemra in hospitalized patients.

Overall, Roche’s performance in the first quarter was “quite resilient,” with sales growing at 7% at constant currencies, but still the pandemic has “impacted us significantly,” CEO Severin Schwan said.

In contrast to Actemra’s unusual growth, age-related macular degeneration med Lucentis—to which Roche holds U.S. rights—dropped 13% in sales over Q1 last year, reaching CHF 387 million ($398 million). Last year, the med’s sales rose 8%.

In a recent note based on IQVIA data, Bernstein analysts already noted a sharp decline in U.S. scripts of ophthalmology drugs, including Allergan’s dry eye med Restasis. And they speculated the sign spells bad news for Lucentis rival Eylea from Regeneron.

“What is happening is patients are just delaying their appointments … because they are so worried to potentially be infected, or because in certain countries they are even asked not to leave their homes and only go to hospitals in very acute cases,” Schwan explained.

But still, thanks to a different market dynamic caused by COVID-19, pulmonary fibrosis drug Esbriet rose 22% year over year to hit CHF 292 million ($301 million) in Q1 sales, compared with just 9% growth in 2019. Anderson attributed the fluctuation to a stocking effect as patients avoid going out.

Expected biosimilar competition to the company’s three best-selling drugs—Herceptin, Avastin and Rituxan—dealt about CHF 857 million ($885 million) in damage, with the majority coming from the U.S., where copycats just entered. But the gap was more than filled by newer drugs, including PD-L1 Tecentriq, multiple sclerosis antibody Ocrevus and hemophilia A therapy Hemlibra, which collectively turned up an additional CHF 1.58 billion in sales compared to the same period last year.

However, Ocrevus’ 38% growth marked a slowdown from the 57% it saw last year. Part of that also has to do with chronic patients delaying their physician visits. But as Anderson noted, when the novel coronavirus first emerged, concerns came up that Ocrevus’ mechanism of depleting CD20 B cells to manage autoimmunity in MS might hurt the patients’ chance at fighting the virus. Some countries even suggest a delay of the drug. As many registry data are now being collected from MS patients with COVID-19 on various MS therapies, Anderson said the company doesn’t see any alarms at this point and expects to publish these data in the near future.

With biosimilar attacks underway, Roche’s HER2 franchise also experienced some changes. As Herceptin sales declined 24% at an unchanged exchange rate to CHF 1.21 billion ($1.25 billion), Perjeta and Kadcyla have now surpassed it with Q1 sales of CHF 1.01 billion (1.04 billion) and CHF 428 million ($441 million), respectively.

For the quarter, Roche’s pharma sales were up 7% at constant currencies, totaling CHF 12.3 billion in Q1. Its diagnostics division also grew sales by 5% to CHF 2.9 billion, driven mainly by huge demand for its COVID-19 tests, while other routine tests slowed, according to Schwan.

Despite all the changes, Roche is maintaining its full-year sales growth guidance at low- to mid-single digits. It may seem incredible amid a pandemic, but for context, the Swiss pharma boosted its outlook three times last year.