By: Sruthy Iype  Sep. 17, 2020

Dexur’s analysis of Medicare claims data showed that Keytruda was used in the treatment of a higher proportion of merkel cell carcinoma patients compared to Bavencio in 2019. The analysis looked at the J code usage of the drugs (J9271/J9023) among Medicare patients who received treatment in hospital outpatient settings between Jan 2018 and Dec 2019. The study 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 Bavencio (avelumab), are immune checkpoint inhibitors belonging to the PD-1/PD-L1 drug class. By targeting the PD-1/PD-L1 (Programmed cell death protein 1/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 and slows down the progression of the disease.

Pfizer and Merck KGaA's Bavencio was the first FDA-approved (March 2017) immunotherapy drug for merkel cell carcinoma (MCC), a rare type of skin cancer that affects about 2000 individuals in the U.S each year. The drug went on to gain approvals for indications of urothelial carcinoma and renal cell carcinoma in later years. Offering stiff competition to it is Merck’s blockbuster cancer drug Keytruda that received approval for the treatment of MCC in December 2018. Keytruda holds approval for the treatment of several types of cancer including indications of melanoma, non-small cell lung cancer, small cell lung cancer, head and neck cancer, urothelial carcinoma, and renal cell carcinoma.

Bavencio dominated the MCC market in 2018 compared to Keytruda by a considerable margin. During this period, Bavencio was administered to a total of 297 patients affected by MCC whereas Keytruda was administered to 205 patients diagnosed with the condition.

However, a complete reversal was seen in the proportion of MCC patients treated with the two drugs in the following year. Exhibiting a 67 percent year-over-year increase, Keytruda’s patient share surpassed Bavencio in MCC in 2019. While 343 patients were treated with the former, 245 patients were administered with the latter during this period.

A significant difference was also observed in the average usage per patient for both the drugs; while a MCC patient had about 5.6 claims per year for Keytruda, an average of 10 claims was filed per patient for Bavencio.