Nexium challenged by P-CAB…attempts at regaining sales

After its launch in 2000, Nexium has become the domestically approved PPI with the most indications in South Korea

PPI monotherapy sales have been decreasing…Nexium's sales have shown a decreasing trend after 2021

Strengthening AstraZeneca-Ildong pharmaceutical partnership

Proton pump inhibitors (PPIs) are being challenged by emerging P-CAB drugs.

 

Therefore, Nexium's company is strengthening strategic partnerships to maintain Nexium's market position.

 

The company continues partnering with Ildong Pharmaceutical and plans to continue collaboration based on its years of prescription experience.

 

(from left) Ji-Young Kim, executive director of AstraZeneca Korea, Hwoon-Yong Jung, Professor in the Department of Gastroenterology at Asan Medical Center in Seoul, and Sang Gyun Kim, Professor in the Department of Gastroenterology at Seoul National University Hospital.

AstraZeneca Korea announced this on February 20 at the press conference celebrating its 25-year anniversary of the South Korea launch of gastroesophageal reflux disease (GERD) treatment Nexium (esomeprazole magnesium trihydrate).

 

Launched in 2000, Nexium is one of the major PPI treatments that works by suppressing gastric acid secretion.

 

It has six indications, including GERD, and has the most indications among domestically approved PPIs.

 

After 25 years since the launch of this drug, the effects on superior acid control and the improvement of GERD, as well as the effectiveness and safety profile of long-term administration, have been confirmed through various clinical practices.

 

Nexium has been recorded as No.1 in accumulative prescription volume for 10 years in the global GERD treatment market, including PPI and P-CAB.

 

Dr.

 

Hwoon-Yong Jung, Professor in the Department of Gastroenterology at Asan Medical Center in Seoul, said, "Nexium is a s-isomer-based PPI with a superior treatment rate in 98.9% of patients with GERD.

 

It has established a firm position in the market." Dr.

 

Jung added, "It secured various indications, including maintenance therapy following intravenous injection to prevent rebleeding related to gastric ulcer.

 

It is now known to provide a wide variety of treatment options." However, as the growth rate of PPI monotherapy has been decreasing, the company has deep concerns.

 

According to market research firm UBIST, last year's outpatient prescription sales in the PPI monotherapy market were KRW 636.2 billion.

 

The PPI monotherapy market steeply rose until 2021.

 

After that, the growth rate significantly decreased.

 

The prescription sales of PPI monotherapy in 2019 were KRW 461.7 billion and then increased by 19% to KRW 550.1 billion the following year.

 

In 2021, the sales increased by 9% to KRW 600.4 billion.

 

In 2022, the sales increased by only 2%, with KRW 614.3 billion.

 

In 2023, it increased by 2% with KRW 624.5 billion.

 

Last year, it rose by 2% compared to the previous year.

 

After 2022, it grew 2% in three consecutive years.

 

Analysis suggests that the introduction of P-CAB drugs has contributed to this sales trend.

 

P-CAB drugs have a longer duration of drug action compared to PPI drugs, so they are also effective for managing night-time gastric acid secretion.

 

They also have the advantage of combining with other medications because it is less likely to interact with other drugs.

 

The total prescription sales of P-CAB drugs show a high growth rate: ▲2019, KRW 30.4 billion▲2020, KRW 77.1 billion ▲2021, KRW 110.

 

7 billion ▲2022, KRW 146.3 billion ▲2023, KRW 217.2 billion ▲2024, KRW 286.4 billion.

 

Despite defending the market position, Nexium is seeing decreasing sales.

 

The recent sales of Nexium indicate that its sales have been decreasing after recording the highest sales in 2020, with KRW 45.6 billion: ▲2021, KRW 42.0 billion ▲2022, KRW 33.5 billion ▲2023, KRW 32.3 billion ▲2024, KRW 29.1 billion.

 

Despite this trend, experts view that Nexium will maintain its market position.

 

Apart from the P-CAB drugs' effect, the long-term trend can be closely watched.

 

Dr.

 

Jung said, "New drug releases attract attention and can lead to increased usage, but existing drugs still have advantages and remain in use." Dr.

 

Jung added, "P-CAB development has provided an additional treatment option that can enhance drug action in patients who are experiencing a decrease in the drug effectiveness." Dr.

 

Sang Gyun Kim, Professor in the Department of Gastroenterology at Seoul National University Hospital, said, "The degree of symptom improvement experienced by patients are not significantly different between PPI and P-CAB.

 

If a disease is effectively managed by PPI, there is no need to change the medication." Dr.

 

Kim added.

 

"We have to wait to see which medication will benefit patients more.

 

Given that P-CAB has not been in the market for so long, we still need to monitor its long-term usage."

Bae Yong-Chan, Executive Director of Ildong Pharmaceutical

Along with this, AstraZeneca and Ildong Pharmaceutical plan to maintain their influence on the market by strengthening their partnership.

 

Bae Yong-Chan, Executive Director of Ildong Pharmaceutical's ETC division, said, "Besides the gastroenterology area, we are strengthening partnerships to pave the way for cardiovascular diseases area.

 

Also, Nexium's long-term maintenance therapy will still be its advantage." Bae added, "Nexium is a trusted medication that has contributed to improving patient quality of life.

 

Ildong Pharmaceutical, in collaboration with AstraZeneca, is expanding Nexium's value.

 

We will strive to create the best treatment settings through continued collaboration."