Goodbye Plavix, hello competition

Plavix ceded 90% of its market share to generics within two months
Plavix ceded 90% of its market share to generics within two months

Longtime mega-blockbuster Plavix (clopidogrel bisulfate) has gone to the branded drug beyond. The Bristol-Myers Squibb brand, far and away the No. 1 anti-platelet drug in the US from 2007 through 2011 and briefly the successor to Lipitor as biggest of all blockbusters, lost patent exclusivity Thursday.

Plavix raked in $27.2 billion in US sales alone over the past five years, so you might expect wailing and rending of garments from investors, but analysts aren't sweating it. Bernstein's Tim Anderson said in a March report that the impact will be mitigated, in part, by new drugs. “BMS is, far and away, the company that will have the biggest revenue contribution from new pipeline drugs through 2016,” said Anderson.


Business intelligence firm The Zitter Group's Managed Care Message Monitor shows “more messages for [AstraZeneca's Brilinta] than for any other product currently approved for acute coronary syndrome (64% of messages captured in the anticoagulant category), with a clear claim of superiority over Plavix,” in patients with acute coronary syndrome, along with quicker onset of action, they wrote. “Further competitive messaging is focused on Effient as a direct competitor, stressing the fact that Brilinta has a more favorable safety profile, while highlighting bleeding risks seen with Daiichi Sankyo's product.” Lilly and Daiichi Sankyo's "Effient messaging also claims superior efficacy and safety to Plavix, with particular emphasis on the former product's effectiveness following stent insertion surgery,” said Zitter. “Both AstraZeneca and Daiichi Sankyo are touting their superiority to Plavix, but Brilinta messaging is also competitive towards Effient.”

Johnson & Johnson's Xarelto (rivaroxaban) is not officially a Plavix competitor—the FDA hasn't cleared it for the same indication, although it's currently awaiting approval for use in reducing the risk of new heart attacks and stroke, as well as clots, in patients with acute coronary syndrome. Zitter says J&J's roundabout approach talks up how Xarelto compares to warfarin for atrial fibrillation and stroke prevention, while stressing its more convenient dosing compared to Boehringer Ingelheim's Pradaxa. Boehringer is trumpeting Pradaxa's superiority in efficacy over Xarelto.

Note: The initial version of this post incorrectly said Zitter's MCMM data has been logged since 2001. In fact, it covers only the past six months. We also wrongly said 46% of Brilinta's messaging compared the AZ product to Plavix—rather, 64% of messages captured in the anticoagulant category concerned Brilinta.