In the first year of the respiratory syncytial virus (RSV) vaccine battle, GlaxoSmithKline’s (GSK) Arexvy emerged as the winner over Pfizer’s Abrysvo.
GSK declared Arexvy to be a blockbuster in its first year on the market after higher-than-expected sales. GSK revealed in its 2023 annual and quarterly earnings report last week that sales of Arexvy totaled $1.5 billion or £1.2 billion in 2023, higher than its $1 billion estimation.
Meanwhile, Pfizer isn’t too pleased with Abrysvo’s early performance as its inaugural year revenue of $890 million fell short of expectations.
Going up against vaccine stalwart Pfizer wasn’t an easy feat but GSK succeeded in the challenge by taking an early lead in the RSV vaccine battle. GSK said it has secured about two-thirds share of the US market where nearly all of Arexvy’s sales were recorded.
At the same time, the British drugmaker knows Pfizer could quickly catch up. Despite coming in second to Arexvy in year one, Abrysvo has been on an upward trajectory with sales having jumped from $375 million in the third quarter of 2023 to $515 million in the fourth.
Arexvy and Abrysvo, the world’s first vaccines against RSV, were approved in 2023 and have been head-to-head competitors since their US Food and Drug Administration (FDA) approvals for individuals 60 years of age and older, which were granted just weeks apart. A few months later, in August, Abrysvo also received approval for maternal use, indicated for pregnant individuals to prevent lower respiratory tract disease (LRTD) including severe LRTD caused by RSV in infants from birth to six months of age.
RSV infection can lead to serious complications, particularly among older adults, children and individuals with weakened immune systems or other medical conditions, which can lead to hospitalization.
In its 2023 annual report, Pfizer said Abrysvo’s revenues were mainly driven by its approval in the older adult indication.
Arexvy has helped resurrect GSK’s dwindling vaccine division, which saw an increase of 25 percent in sales in 2023 over last year.
There is significant ground to capture as only ten percent of Americans received an RSV vaccine last year. According to GSK, about 6 million of the 83 million adults 60 years or older in the US received Arexvy.
The RSV vaccine battlefield may see a third player this year with Moderna anticipating regulatory decisions on its mRNA-based RSV vaccine, which the company is expecting to receive in the first half of 2024. The company has reported the vaccine to be 83.7 percent effective against RSV-associated LRTD as defined by two or more symptoms, and 82.4 percent as defined by three or more symptoms among participants that were at least 60 years old.
On a conference call to discuss GSK’s 2023 earnings report, the company’s chief commercial officer, Luke Miels said the company was “very pleased with the launch so far and the 2023 performance but our mindset is, this is the first round of a multi-found fight.”
And in 2024, he said “we’ve got a third boxer jumping into the ring to make things interesting.”
Nevertheless, Miels said the company remains “very confident this vaccine can achieve more than £3 billion in peak year sales over time.”
He also noted that RSV awareness is already “remarkable” at around 86 percent in the US. Additionally, “The willingness to prescribe and recommend on the part of doctors is very, very positive.”
GSK also shared its long-term plans, which include the launch of at least 12 notable products and a goal of £38 billion or $48 billion in sales by 2031.
For Arexvy, the company is seeking expanded approval for adults 50 to 59 years old for a further boost.
On the other hand, Pfizer didn’t appear to have high hopes for Abrysvo to start the year. At the J.P. Morgan Healthcare Conference in January, Pfizer CEO Albert Bourla said the RSV shot was a “bad launch” for the company.
Pfizer also hesitated to comment on its forecast for Abrysvo in 2024, and instead, gave a bigger picture outlook.
“We’re very focused going forward on retail contracting for the 2024-25 season,” said Amir Malik, Pfizer’s new US commercial officer. “We’re going to also focus on new opportunities that we’re currently studying with Abrysvo — adults aged 18 and older with underlying medical conditions.”
Bourla also said the company is focused on increasing Abrysvo’s market share by establishing RSV vaccination as a year-round “discussion.”
It was also “encouraged” by sales of Abrysvo as a maternal vaccine.
“More than 65 percent of women prefer to get the maternal vaccine versus having their infant immunized by a monoclonal antibody, and we think that the label provides us the opportunity to grow that segment as well,” Malik said.
In addition to promoting uptake in the US, GSK and Pfizer are also focused on expanding in the global market. Arexvy is currently approved in 39 countries with nine having issued recommendations for use but just four with reimbursement deals. Miels said it’s still “early days” of the launch and that China is a significant target base.
Abrysvo is approved in all European Union (EU) member states as well as Iceland, Liechtenstein and Norway. The broad approval highlights its significance as a preventive measure against RSV, aiming to protect both older adults and infants through maternal immunization.
GSK’s 2023 sales registered in at £30.3 billion. The company said it is expecting growth between five and seven percent in 2024 and over seven percent through to 2026.
The RSV vaccine market is anticipated to undergo significant growth, with projections by GlobalData suggesting an expansion from $1.2 billion in 2022 to $9 billion by 2029.