Healthcare


Merck and Pfizer - Strange bedfellows?

by Deborah Toscano 30 Apr 2013
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In a surprising announcement made yesterday, Merck and Pfizer are teaming up to commercialize Pfizer’s SGLT2 inhibitor ertugliflozin for diabetes.  This announcement took the pharma world by surprise, especially since Merck in particular is not known for forming partnerships with other big pharmas.  Typically these partnerships leverage the individual areas of expertise of each company, and in this case it would seem to be Pfizer’s compound and well-demonstrated marketing expertise along with Merck’s solid performance in the diabetes therapeutic area as demonstrated by the success of Januvia, the first-in-class DPP-IV inhibitor.  However, the diabetes add-on market is now cluttered with DPP-IV inhibitors and interest has moved on to other novel therapeutics, such as SGLT2 inhibitors, the first of which, Johnson & Johnson’s Invokana (canagliflozin), has just entered the U.S. market.  Although Januvia still holds the lead among DPP-IV inhibitors and is not likely to lose that position any time soon, newer classes such as SGLT2 inhibitors could start to eat away at DPP-IV market share once physicians get comfortable with them.  While SGLT2 inhibitors have glucose control efficacy on par with DPP-IV inhibitors, they are viewed as having several key additional benefits, notably weight loss and positive effect on blood pressure which could translate into cardiovascular benefit.  They do, of course, also have several negatives such as an association with genital and urinary tract infections (SGLT2 inhibitors work by helping the body shed excess glucose through the urine) and contraindication in patients with severe renal disease since they work through the kidneys.  Regulatory approval of this class was a point of great uncertainty for quite a while, but now that the first one has gotten its foot through the door, Merck was likely more receptive to the idea of adding one to their diabetes portfolio.  Two other SGLT2 contenders are already partnered:  Bristol-Myers Squibb’s dapagliflozin, partnered with AstraZeneca (approved in Europe but still awaiting U.S. approval); and Boehringer Ingelheim’s empagliflozin, partnered with Eli Lilly.  Both of those partnerships also give access to a DPP-IV for an attractive SGLT2 + DPP-IV fixed-dose combination: dapagliflozin with Bristol’s saxagliptin, and empagliflozin with BI’s linagliptin. With the Pfizer/Merck partnership, a fixed combination of Januvia and ertugliflozin is now a possibility.  Moreover, Pfizer stands to gain from Merck’s experience in speeding Januvia through development and market launch.  So, as strange as it may seem considering their respective histories, this partnership makes great commercial sense.

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