Regeneron has a winner in Dupixent and big sales hopes. So why are so few patients taking it?

05 Feb 2021
One of the true biotech success stories, New York’s Regeneron has set its ambitions sky high with two blockbusters in their back pocket and some potential winners in the pipeline. But one of those bestsellers, immunology med Dupixent, hasn’t taken off quite as expected. Despite more than three and a half years on the market and its parent companies’ pitch as a better biologic for eczema, IL-4 med Dupixent is still sitting at a meager 6% market share of its 2.2 million eligible patients in the US, Regeneron execs said on a fourth-quarter earnings call with analysts Friday. The reason? Market education, Regeneron reckons — and there’s still a lot of work to be done. In eczema, also known as atopic dermatitis, Regeneron and partner Sanofi have staked most of Dupixent’s growth potential as the first-to-market drug , but physicians and patients have taken a long time to catch on because there had been “so little for so long” in terms of treatment options, the New York drugmaker said. Those lack of prior options, in Regeneron’s telling, could mean patients and their specialists aren’t actively seeking therapies. According to CEO Len Schleifer, Dupixent’s injectable formulation could also be partly to blame since patients view therapies like Dupixent as “more serious” than oral meds. “There’s a lot of education that needs to be done,” he said. “There’s a long legacy that meds you can take by mouth are not as serious drugs as drugs you take by injection. Most sophisticated people are beginning to realize it’s the biologicals that are more targeted, more natural and less prone for off-target and on-target toxicities.” Even still, with just 6% access, Dupixent is a blockbuster medicine — a fact that underscores its potential to drive Regeneron’s top line. The drug pulled more than $4 billion in sales in 2020 on a sparkling 75% growth clip, and Regeneron’s expecting big readouts in eosinophilic esophagitis and prurigo nodularis this year. Driven by Dupixent’s growth and the continued success of anti-VEGF therapy Eylea, Regeneron posted $8.5 billion in sales in the year 2020 — a 29% growth rate that should go a long way to bolstering the drugmaker’s leaders’ high hopes for the future. In early January, Regeneron’s board agreed to rework Schleifer and CSO George Yancopoulos’ bonus compensation, putting $1.4 billion on the table in future payouts if the drugmaker keeps the good times rolling. Regeneron linked both execs’ future compensation to the cumulative share-price growth over five years with a three-year holding period after the performance-restricted stock units (PSU) fully vest. The board set tiered milestones for both executives’ possible awards with a target goal of 65.6% growth on Regeneron’s most recent closing share price prior to the vote of $478.30. Hitting that number on the nose would earn both Schleifer and Yancopoulos a cool $196.5 million each. On the absolute high end — 140% share growth over five years at a 19.2% annual rate — both Schleifer and Yancopoulos would be due a whopping $713.3 million.
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