This is the first time government advisers have recommended routine use of a pneumococcal vaccine for certain risk groups within the 19-64 age bracket, a move that could “meaningfully increase” peak sales potential for the shots, Cantor Fitzgerald analyst Louise Chen wrote in a note to clients.
Before the panel met, there was some anticipation that experts might state a preference for Pfizer’s vaccine, Chen wrote. Instead, the battle between Pfizer and Merck will be decided in the market, as doctors choose which shots to order for their patients.
Both of the next-generation vaccines are still very new to physicians. Pfizer won Food and Drug Administration approval of Prevnar 20 in June, and Merck’s Vaxneuvance received clearance in July.
Prevnar 20 is designed to protect against more strains of the pneumococcal bacteria that can cause lung, ear, sinus and blood infections compared to Pfizer’s older Prevnar 13, which is widely used and routinely given to children under the age of 2. It’s one of Pfizer’s best-selling products, bringing in $1.2 billion in the second quarter alone.
To date, Prevnar 13 has widely outsold Merck’s older product, Pneumovax23, which had revenue of $152 million in the second quarter. Merck is looking to change that competitive dynamic with Vaxneuvance, which research showed spurred greater immune responses than Prevnar 13 against three key strains.
For the populations covered by the ACIP recommendations, Pfizer’s Prevnar 20 may have an edge because patients would need only a single dose, instead of Vaxneuvance followed by Pneumovax 23. But Pfizer’s overall market share is likely to be lower because of the ACIP vote, wrote SVB Leerink analyst Geoffrey Porges.
Porges now expects Merck to nab close to 40% of the market, up 20% — or roughly $700 million, based on last year’s U.S. sales — from previous expectations.
Merck is also positioned to beat Pfizer to the pediatric market, with a filing planned for later this year. Pfizer, by contrast, expects data from a large pediatric trial for Prevnar 20 in 2022, according to a federal database of clinical trials.