Recently, FiercePharma released the 2019 global drug sales list Top 20. Among them, Aberdeen's Humira won the crown again with sales of $19.73 billion, winning the title for the eighth year in a row, but sales are down from last year.

After Humira is a series of super antineoplastic drugs.Especially in the aspect of PD-1 antibody.。Merck & Co Inc's Keytruda (K medicine) and BMS's Opdivo (O drug) ranked second and fifth with sales of US $11.13 billion and US $8.06 billion respectively.

(note: PD-1 antibody is a broad-spectrum anticancer drug, which kills cancer cells by activating the body's immune system, so theoretically, a drug can treat lung cancer, liver cancer, breast cancer, gastric cancer and other cancers.)

Merck & Co Inc's K medicine rose one place to second place compared with last year, an increase of 54%. Single drug sales in 2019 were 11 billion US dollars (about 77 billion yuan). He is expected to become the "king of medicine" in 2022. (the annual income of China's pharmaceutical leader Hengrui Pharmaceutical is 23.2 billion yuan in 2019.)

BMS's O drugs rose two places to fifth place from last year, an increase of 5.8%, with revenues of $8 billion in 2019.

Comparison of K and O drugs

1）Merck

Merck & Co Inc earned $22.929 billion in revenue in the first half of 2020, + 2 per cent year-on-year. Among them, Merck & Co Inc's growth is mainly caused byTumor和VaccineA strong push, justKeytruda (K medicine)It accounts for 29% of the total revenue, + 36% year-on-year, reaching US $6.672 billion. The growth of K Pharmaceutical plays a key role in the company's total revenue.

Merck & Co Inc's star product Keytruda (K medicine) went on sale in September 2014. after five years on the market, it has become the second largest single drug by sales in the world, and is expected to become the "king of medicine" in 2022. This reflects the strong market penetration of K in the field of non-small cell lung cancer (NSCLC). Of course, other indications such as kidney cancer and melanoma are also a great help to expand the market.It is worth noting that there are as many as 1200 clinical studies of drug K worldwide.There is still a nine-year patent term.Compared with other star drugs, the market space is huge.

2) BMS

BMS had global revenue of US $20.91 billion in the first half of 2020, a year-on-year increase of 71% (mainly due to the merger and acquisition of Xinji); leading productsRevlimidIn the first half of 2020, sales reached US $5.799 billion, accounting for 28% of the total revenue, squeezing out the anticoagulant Eliqus to become the leader of BMS!OPdivo's revenue in the first half of 2020 was $3.419 billion, accounting for 16% of the total revenue,-6% year-on-year.。

Before 2017, the sales of O drugs were ahead of K drugs. However, after drug K was approved for lung cancer, gastric cancer and other indications, and the efficacy of drug K is good, it has become a first-line treatment for many large cancers, and the sales of drug K began to far exceed that of drug O in 2019.

Behind Merck & Co Inc and BMS is the strong support from K medicine and O medicine! However, domestic PD-1 is not inferior.

The situation of PD-1 Pharmaceutical Enterprises in China

1）INNOVENT BIO

INNOVENT BIO's PD-1 productsXindirizumab injection(da Boshu) listed in March 2019, with an annual revenue of 1.02 billion yuan, is the only product sold by the company, accounting for 97%. The sales figure for the first half of 2020 was 900 million yuan, which is equivalent to the revenue of last year.This year, the sales volume of INNOVENT BIO's Xindili monoclonal antibody is expected to reach 2 billion.。

It is worth mentioning that INNOVENT BIO's Cindilizumab entered the national health insurance catalogue last year, becoming the only PD-1 drug to enter the national health insurance catalogue. At the same time, Xindirizumab is the only oneThe field of lung cancerAmong the approved domestic PD-1 drugs, there are about 900000 new cases of lung cancer in China every year, ranking first among the major cancer species in China. NowFirst-line liver cancerThe treatment is in the critical II/III phase of the study, and five indications are expected to be approved by Cindilizumab from 2020 to 2021.

(one of the reasons why the gap between K and O drugs has been widened is whether the indications for lung cancer can be approved.)

2）Hengrui medicine

In May 2019, Hengrui MedicineCarrilizumabApproved for listing, the revenue of Carrell Monoclonal Antibody in 2019 is 1.5 billion + yuan, accounting for 6% of the total revenue. In the first half of 2020, Hengrui's PD-1 productsCarelli Zhuzumab isThe best-selling drug among the 7 PD- (L) 1 drugs on the Chinese marketSales have exceeded 2 billion yuan.In one fell swoop, it surpassed the domestic sales of Merck & Co Inc K drugs.

Hengrui Pharmaceutical, as the leader of domestic innovative drugs, has an incomparable foundation in China, and has become a leader in the field of tumor immunotherapy in China. Especially in terms of sales, Heng Rui has a total sales staff of 1.5-16000 people, including more than 5000 tumor lines. INNOVENT BIO has 688 sales staff in 2019 and 359 in the sales department as of February 2020.

Hengrui PD-1 productCarrilizumabIn as many as 15 clinical trials conducted, the side effects of the combination were the weakness of Hengrui, including hemangioma side effects in the combined clinical trials with Incyte. Although Hengrui's PD-1 has obvious side effects, its short-term sales advantage is very obvious with its strong domestic sales network.

3）Junshi creature

Junshi's triplet monoclonal antibody was listed in December 2018, becoming the first approved PD-1 pharmaceutical company in China. However, sales of triplizumab in 2019 were only 774 million yuan, accounting for 100% of revenue, which was lower than that of INNOVENT BIO's Xindili Monoclonal and Hengrui Pharmaceutical's Carrilizumab. It is estimated that the income in 2020 will exceed 1 billion yuan.

Compared with Heng Rui and INNOVENT BIO, Junshi Biological focus has a lower incidence and lack of clinical indications for direct treatment, such as melanoma.

At present, among the four PD-1 McAb companies listed in China, only Junshi Bio is aimed at melanoma, while Bristol-Myers Squibb Co and Merck & Co Inc are strategically abandoned in this field. Nasopharyngeal carcinoma and urothelial cancer, which were approved for second-line treatment in April and May 2020 respectively, are also small cancers in China.

Summary

As Merck & Co Inc's K drug became a first-line treatment for many large cancers, Merck & Co Inc's K drug sales began to far exceed BMS's O drug. Sales of K drugs increased by 54% in 2019, with sales of US $11 billion, making it the second best-selling medicine in the world. It is expected to become the "king of medicine" in 2022.What is noteworthy is thatThere are as many as 1200 clinical studies of K drugs worldwide.There is still a nine-year patent term.Compared with other star drugs, the market space is huge.

Behind Merck & Co Inc and BMS is the strong support from K medicine and O medicine! However, domestic PD-1 is not inferior. Domestic enterprises that have listed PD-1 drugs: INNOVENT BIO, Hengrui Pharmaceutical and Junshi Biology. There is no doubt that the best drug effect is INNOVENT BIO's Xindirizumab, which entered the national health insurance catalogue in 2019 and became the only PD-1 drug that entered the national health insurance catalogue. Hengrui Pharmaceutical, as the leader of domestic innovative drugs, with its strong domestic sales network, its sales in the first half of 2020 has exceeded 2 billion yuan, surpassing the domestic sales of Merck & Co Inc K drugs. At present, the only indication of Junshi biology is melanoma, and the incidence rate is low in China.Time to market is the advantage, short-term marketing, long-term efficacy can determine the final ownership。

Investment suggestion

Us stocks: Merck & Co Inc

A shares, Hong Kong stocks: Heng Rui Pharmaceutical, INNOVENT BIO