By: Sruthy Iype Sep. 10, 2020
Dexur’s analysis of Medicare claims data showed that Keytruda has three times the market share as Opdivo in lung cancer, whereas Opdivo has twice the market share as Keytruda in Melanoma. The analysis looked at the J code usage of the drugs (J9271/J9299) among Medicare patients who received treatments in hospital outpatient settings between Jan and Dec 2019. The analysis also looks at the average claims per patient data, which is a proxy for the number of injections / IV infusions / doses administered to a patient.
Keytruda (pembrolizumab) and Opdivo (nivolumab), manufactured by Merck and Bristol-Myers Squibb respectively, are PD-1 (Programmed cell death protein 1) inhibitors used as immunotherapy in the treatment of various advanced types of cancer. By targeting the PD-1/PD-L1( Programmed death ligand 1) pathway that downregulates T-cell activity and helps the cancer cells to escape immune responses, these drugs restore the ability of the immune system to produce anti-tumor responses. The FDA approved indications of the drugs include types of melanoma, non-small cell lung cancer, small cell lung cancer, renal cell carcinoma, classical hodgkin lymphoma, urothelial carcinoma, and hepatocellular carcinoma. This study examines the use of Keytruda and Opdivo with respect to the top 2 types of cancer where its usage has been observed.
Lung cancer accounted for the largest proportion of both Keytruda and Opdivo’s usage in 2019, followed by Melanoma. Lung cancer patients had an average of 5.6 claims per year for Keytruda and 6.3 claims per year for Opdivo. Meanwhile, melanoma patients had an average of 6 claims per year for Keytruda and 5.5 claims per year for Opdivo.
| Total patients administered Keytruda | Total Claims for Keytruda | Total Payments for Keytruda | Total patients administered Opdivo | Total Claims for Opdivo | Total Payments for Opdivo | Ratio of total patients | Ratio of total claims | Ratio of total payments | |
|---|---|---|---|---|---|---|---|---|---|
| Lung Cancer | 18,383 | 102,292 | $773,346,380 | 6,291 | 39,343 | $278,721,045 | 2.9 | 2.6 | 2.8 |
| Melanoma | 2,571 | 15,388 | $110,820,138 | 4,678 | 25,913 | $197,716,765 | 0.5 | 0.6 | 0.6 |
When compared to Opdivo, Keytruda led by a huge margin in the lung cancer market. Between Jan and Dec 2019, lung cancer patients who were administered Keytruda exceeded those who were administered Opdivo by nearly 3 times. The associated share of claims and payments for both the drugs also exhibited a similar trend.
Meanwhile, Opdivo’s market share in melanoma was noted to be significantly higher in comparison to Keytruda. Melanoma patients who were administered Opdivo, were twice as many as those who were administered Keytruda, during this period. Subsequently, the corresponding share of claims and payments also followed a similar trend.