Market opportunity in 2019
In Bristol-Myers Squibb’s (BMY) third-quarter earnings conference call, the company estimated the contribution of lung cancer indication to Opdivo’s US market revenues to be close to 35%. The contribution is higher at ~60% in ex-US markets. The company expects the addressable market size for Opdivo in the second-line NSCLC (non-small cell lung cancer) indication to gradually decline in future years.
According to Bristol-Myers Squibb’s Evercore ISI HealthCONx Conference transcript, the company expects 35%–40% of the total NSCLC patients to be eligible for the company’s immune-oncology therapy in the second-line setting by the end of 2019. The estimate is based on the assumption that the penetration of immune-oncology therapies in the first-line NSCLC setting will be ~70%–75% by the end of 2019.
According to Bristol-Myers Squibb, the immune-oncology penetration in the first-line NSCLC market, which includes competing monotherapy and combination regimens, is ~50%. The remaining 50% are on chemotherapy or are starting chemotherapy—a major part of the target market for second-line treatment with Bristol-Myers Squibb’s Opdivo therapy.
According to the company, lung cancer patients with epidermal growth factor receptor mutations, who aren’t treated with first-line immune-oncology therapy and can be treated based on nucleus tractus solitarius regulation, are expected to become a part of the addressable market for Bristol-Myers Squibb’s immune-oncology franchise in second-line and third-line settings. Bristol-Myers Squibb also expects close to 10% of the patients treated with immunotherapy in the first-line setting to be eligible for retreatment in the second-line setting.
Next, we’ll discuss the future growth drivers for Bristol-Myers Squibb’s Opdivo in lung cancer indication.