Pfizer in the center of autoimmune disease treatment scene

Interview on Pfizer Korea Inflammation & Immunology Business Unit Lead Kim Hee-yeon

Leading the market by accentuating unique strengths of Enbrel and Xeljanz

To rise above competition with generics with expanded indication and differentiated marketing strategy

I&I Business Unit Lead Kim Hee-yeon

Shifting the paradigm in autoimmune disease, tumor necrosis factor (TNF)-α inhibitors have taken root as major treatment option not only for rheumatoid arthritis, but also for other various areas including ankylsoing spondylitis, psoriasis, and psoriatic arthritis.

 

Regardless, there are still patients struggling with unmet needs as they fail to control the diseases with TNF-α inhibitors.

 

As a result of many pharmaceutical companies jumping into developing alternatives of TNF-α inhibitors, other options like Janus kinase (JAK) inhibitor and interleukin (IL) inhibitors have emerged.

 

Considering the change in treatment scene, Pfizer is a key player in the autoimmune disease area.

 

The company owns a conventional TNF-α inhibitor Enbrel (etanercept), but also it launched a first-in-class JAK inhibitor Xeljanz (tofacitinib).

 

The company is also in process of seeking approval on the Xeljanz follow-up drug ‘abrocitinib.’ Daily Pharm interviewed Pfizer Korea’s Inflammation & Immunology (I&I) Business Unit Lead Kim Hee-yeon on the trend in autoimmune disease drug and marketing strategies.

 

-Please tell us about your experience in the industry.

 

Currently, I am leading the I&I unit in Pfizer Korea.

 

From 2001 when I joined Pfizer Korea, I have acquired a wide variety of drug marketing and sales experiences in internal medicine, pain, respiratory and I&I areas.

 

While managing numerous drugs’ commercial strategies, I was in charge of launching Caduet (amlodipine), Eliquis (apixaban) and Viviant (bazedoxifene) in South Korea, and also leading the off-patent marketing strategy for Lyrica (pregabalin) in seven countries as a regional marketing director in Pfizer Asia.

 

-The I&I unit consists of two key products.

 

What are the respective strengths of those products?

 

Enbrel, launched in South Korea in 2003, has over 16 years of a long history.

 

As a first TNF-α inhibitor in the treatment area, it has been evaluated to have changed the paradigm of rheumatoid arthritis treatment.

 

More than anything, the drug was able to maintain the market leadership with even a specific patient group dedicated to it as it is a TNF-α inhibitor without anti-drug antibodies (ADAs).

 

And its trustworthy safety profile is its one of best strengths.

 

Xeljanz has also proposed a new treatment paradigm in rheumatoid arthritis.

 

A first JAK inhibitor used in rheumatoid arthritis, Xeljanz was listed for reimbursement in 2017 as a first-line therapy after it was released in South Korea in 2014.

 

-The two drugs have an overlapping indication, which could put them in competition.

 

As a business unit, what are the marketing strategies like?

 

Rather than competitors, the two drugs are actually in mutually beneficial relationship.

 

Except for the rheumatoid arthritis, Enbrel and Xeljanz do not share other common indications.

 

Enbrel is indicated to treat patients with ankylsoing spondylitis, and it has been concentrating on the juvenile idiopathic arthritis (juvenile polyarthritis, extended oligoarthritis, psoriatic arthritis, and enthesitis) with healthcare reimbursement expanded last year.

 

Especially, the patients and healthcare providers were exhilarated about the access to the treatment as the juvenile idiopathic arthritis market had highly unmet medical needs.

 

On the contrary, Xeljanz is focused on rheumatoid arthritis and ulcerative colitis treatment area.

 

Xeljanz may have more overlapping indications with Enbrel in the future as the drug is also constantly expanding its indication, but currently they are not competing against each other.

 

-In terms of South Korean healthcare provider, there seems to be a barrier to prescribe JAK inhibitor.

 

Because of that, it seems questionable if the drug would be able to expand its share in rheumatoid arthritis market.

 

I agree.

 

South Korea still tends to prefer conventional therapy.

 

Despite the accumulating evidences highly recommending early treatment, the country’s healthcare providers seem to linger on using the conventional treatment.

 

There could be many factors, but the patients’ stress on getting injections could be one of them.

 

However, an oral JAK inhibitor like Xeljanz would be able to play a positive role in creating a new rheumatoid arthritis treatment environment.

 

And it would also play a significant role in creating an encouraging environment for healthcare providers to assertively proceed with the treatment.

 

-JAK inhibitor market competition is getting heated up.

 

More competitors are emerging and generics are getting closer to challenge the original as it is a small molecule drug. Within the rheumatoid and digestive system disease treatment areas, Xeljanz would continue to expand its indication to provide as much medical benefit as possible to patients with inflammation and immune diseases.

 

In fact, Xeljanz has the most number of indications for a JAK inhibitor, including rheumatoid arthritis, ulcerative colitis and psoriatic arthritis.

 

Xeljanz is a top drug leading the JAK development program Pfizer is heavily engaged with.

 

The company has already accumulated a vast amount of data on efficacy and safety of the drug tested with various groups of patients.

 

The real world data (RWD) based on a wide array of patient groups is consolidating the healthcare providers’ trust in Xeljanz.

 

As different JAK inhibitors have unique molecule structure, collecting such long-term safety data would also be very unique to Xeljanz.

 

-What is the value of administration convenience in terms of autoimmune disease?

 

Because autoimmune disease require a life-long management, consistent use of the needed drug is essential.

 

Particularly, the company has been seeking for means to provide convenient treatment option to the patients as South Korean patients tend to shun injection and get scared of injections easier than patients in other countries.

 

While Xeljanz has been embodying administration convenience itself, Enbrel—initially launched with pre-filled syringe—introduced a pen type called “MyClic” for patients to conveniently self-inject the treatment.

 

The company also distributes an ambient package to store the injection at a room temperature and a E-base tool to keep 90-degree angle when self-injecting with minimum pain free of charge.

 

-As a Business Unit Lead, what were the difficulties experienced when communicating with stakeholders like healthcare providers or government officials?

 

Pfizer is putting much effort into developing and providing innovative pharmaceuticals in areas with highly unmet medical needs for the patients.

 

Pfizer Korea is also endeavoring to introduce these innovative drugs to the Korean market, and to provide treatment benefits to the patients.

 

However, new drugs like first-in-class drugs are facing a number of limitations when pursuing approval and reimbursement.

 

It is gratifying when cooperating with various stakeholders like healthcare providers and government officials to resolve these limitations, but I also contemplate a lot on how to enhance access to innovative pharmaceuticals even faster for those patients fighting against their diseases in pain.