Teva
soaring out in front on a single product and it is no surprise that the
Generics pack are waiting in the rear ready for the copaxone patents to
expire starting May 2014. However Biogen are backing the most winners
with a staggering $5.8 billion worth of business.
#1 Glaterimer acetate Teva $4.3 billion
#2 Avonex Biogen Idec $3.0 billion
#3 Gilenya Novartis $1.9 billion
#4 Tysabri Biogen Idec $1.7 billion
#5 Betaseron Bayer $1.1 billion
#6 Tecfidera Biogen Idec $0.9 billion
#7 Rebif EMD serono $0.6 billion
#8 Ampyra Biogen Idec $0.3 billion
#9 Aubagio Sanofi $0.2 billion
#10 Extavia Novartis $0.2 billion
Interesting
that sales of Extavia are so much lower than Betaseron, for what is
essentially the same product in different packaging. This shows what
brand loyalty and a bit of marketing can do.
#10. Extavia
(interferon beta-1b)Sponsor/Developer: NovartisDosage strength, form,
and frequency: Recommended dose is 0.25 mg injected subcutaneously every
other day. Generally, start at .0625 mg (0.25 mL) subcutaneously every
other day, and increase over a six week period to 0.25 mg (1 mL) every
other dayMechanism of action: UnknownIndication: Relapsing forms of MS
to reduce the frequency of clinical exacerbations2013 sales: $159 million
#9. Aubagio (teriflunomide)Sponsor/Developer:
Genzyme (Sanofi)Dosage strength, form, and frequency: 7 mg and 14 mg
tablets, once-daily, with or without foodMechanism of action: Pyrimidine
synthesis inhibitorIndication: Relapsing forms of MS2013 sales: About
$226 million (€166 million)1
#8. Ampyra (dalfampridine)
/ FampyraSponsor/Developer: Acorda Therapeutics and Biogen IdecDosage
form and strength: 10 mg tabletsMechanism of action: Potassium channel
blockerIndication: Improve walking in patients with MS2013 sales: $302.301 million
#7. Rebif (interferon
beta-1a)Sponsor/Developer: EMD Serono and PfizerDosage strength, form,
and frequency: 22 mcg and 44 mcg by injection three times per week.
Rebif should be administered, if possible, at the same time (preferably
late afternoon or evening) on the same three days, at least 48 hours
apart each week. Generally, patients should be started at 20% of the
prescribed dose three times per week and increased over a four-week
period to the targeted dose, either 22 or 44 mcg three times per
weekMechanism of action: UnknownIndication: Relapsing forms of MS, to
decrease the frequency of clinical exacerbations and delay the
accumulation of physical disability.2013 Sales: About $622 million (€460 million) through September 30, 2013
#6. Tecfidera (dimethyl
fumarate)Sponsor/Developer: Biogen IdecDosage strength, form, and
frequency: Starting dose: 120 mg twice a day, orally, for seven days,
followed by maintenance dose after seven days: 240 mg twice a day,
orally. Capsules must be swallowed whole and intact. Tecfidera can be
taken with or without food.Mechanism of action: UnknownIndication:
Relapsing forms of MS2013 Sales: $876 million
#5. Betaseron (Betaferon;
Interferon beta-1b)Sponsor/Developer: Bayer HealthCareDosage strength,
form, and frequency: Recommended dose is 0.25 mg via injection every
other day. Generally, patients are advised to start at 0.0625 mg (0.25
mL) via injection every other day, and increase over a six-week period
to 0.25 mg (1 mL) every other dayMechanism of action: UnknownIndication:
Relapsing forms of MS, to reduce the frequency of clinical
exacerbations2013 sales: $1.05 billion (€779 million) as of September 30, 201
#4. Tysabri (natalizumab)Sponsor/Developer:
Biogen Idec6Dosage strength, form, and frequency: 300 mg infused
intravenously over approximately one hour, every four weeksMechanism of
action: Binds to the α4-subunit of α4β1 and α4β7 integrins expressed on
the surface of all leukocytes except neutrophils, and inhibits the
α4-mediated adhesion of leukocytes to their
counter-receptor(s).Indication: Adults with relapsing forms of MS2013
sales: $1.67 billion
#3. Gilenya (fingolimod)Sponsor/Developer:
NovartisDosage strength, form, and frequency: Recommended dose: 0.5 mg
orally once daily, with or without foodMechanism of action: Metabolized
into Fingolimod-phosphate, a sphingosine 1-phosphate receptor modulator
that binds with high affinity to sphingosine 1-phosphate receptors 1, 3,
4, and 5. Fingolimod-phosphate blocks the capacity of lymphocytes to
egress from lymph nodes, reducing the number of lymphocytes in
peripheral blood. The mechanism of action on MS is unknown but may
involve reduction of lymphocyte migration into the central nervous
system.Indication: Relapsing forms of MS, to reduce the frequency of
clinical exacerbations and to delay the accumulation of physical
disability2013 sales: $1.9 billion
#2. Avonex (interferon
beta-1a)Sponsor/Developer: Biogen IdecDosage strength, form, and
frequency: 30 micrograms once a week is recommended. To reduce the
incidence and severity of flu-like symptoms that may occur when
initiating Avonex therapy at a dose of 30 micrograms, Avonex may be
started at a dose of 7.5 micrograms and the dose may be increased by 7.5
micrograms each week for the next three weeks until the recommended
dose of 30 micrograms is achieved.Mechanism of action:
UnknownIndication: Relapsing forms of MS, to slow the accumulation of
physical disability and decrease the frequency of clinical
exacerbations2013 Sales: $3 billion8
#1. Copaxone (glatiramer
acetate)Sponsor/Developer: TevaDosage strength, form, and frequency: 20
mg/mL daily by injection; 40 mg/mL three times per week by injection
(9)Mechanism of action: Not fully understood; believed to act by
modifying immune processes that are believed to be responsible for the
pathogenesis of MS.Indication: Relapsing forms of MS2013 sales: $4.328
billion
