The Food and Drug Administration on Friday approved an injectable version of Merck's biggest moneymaker, cancer behemoth Keytruda. But Merck stock shrugged off early gains and closed in the red.
It will take health care professionals just one to two minutes to administer an under-the-skin shot of Keytruda, says Nancy Ibach, an associate vice president of oncology marketing for Merck. Patients who opt for an injection will also be able to forgo having a port implanted for Keytruda infusions.
"It is an incredible opportunity for patients to have an alternative option to IV," she told Investor's Business Daily. "As a cancer patient, having a port is something that is a constant reminder of the cancer treatment. And we know that it is emotionally heavy for them."
But the news didn't help Merck stock on Monday. Shares closed down 1.4% at 80.40, trading below their 50-day and 200-day moving averages, according to MarketSurge. Merck stock has dropped 18% this year, well underperforming a nearly 3% increase for the broader Medical-Ethical Drugs industry group.
Merck's Bread-And-Butter Drug
Keytruda is one of the biggest cancer drugs on the market, generating nearly $29.5 billion in sales last year. The drug is expected to peak at $33.7 billion in 2028 sales, according to FactSet. But then biosimilar versions of the drug are expected to hit the market, and slowly tamp down on the branded drug's sales.
The under-the-skin, or subcutaneous version, could slow that sales drop off, however. Traditionally, Keytruda requires a 30-minute infusion at a specialized center. The subcutaneous shot can be given in a doctor's office and needs just one to two minutes.
"It can offer them some flexibility as well that, up until recently, didn't exist," Ibach said. "I think it's a great innovation in cancer treatment."
Merck has yet to announce the pricing for subcutaneous Keytruda, which will launch before the end of the month. It will launch for adults and children ages 12 to 17 with solid tumors. The company is also studying the under-the-skin shot in blood cancers.
Under-The-Skin Keytruda
Merck expects 30% to 40% of patients will switch to subcutaneous Keytruda within 18 to 24 months of the launch.
"It's really likely to come earliest in early-stage cancers and monotherapy," Ibach said.
It's important to note Keytruda is used in numerous combination approaches as well. Patients who are already undergoing combined IV therapies might just continue with their infusions. But the shot might be preferred for patients with earlier-stage cancers, those who are adding Keytruda to an oral drug or those who only need Keytruda, alone.
Merck will know more next month. The company is running a study to determine patient preference for the infusion vs. the shot, Ibach said.
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