Last Updated: June 17, 2026

AKYNZEO Drug Patent Profile


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Which patents cover Akynzeo, and when can generic versions of Akynzeo launch?

Akynzeo is a drug marketed by Helsinn Hlthcare and is included in two NDAs. There are twenty-two patents protecting this drug and one Paragraph IV challenge.

This drug has one hundred and ninety-two patent family members in fifty-three countries.

The generic ingredient in AKYNZEO is fosnetupitant chloride hydrochloride; palonosetron hydrochloride. There is one drug master file entry for this compound. One supplier is listed for this compound. Additional details are available on the fosnetupitant chloride hydrochloride; palonosetron hydrochloride profile page.

DrugPatentWatch® Generic Entry Outlook for Akynzeo

Akynzeo was eligible for patent challenges on April 19, 2022.

By analyzing the patents and regulatory protections it appears that the earliest date for generic entry will be May 23, 2032. This may change due to patent challenges or generic licensing.

There have been four patent litigation cases involving the patents protecting this drug, indicating strong interest in generic launch. Recent data indicate that 63% of patent challenges are decided in favor of the generic patent challenger and that 54% of successful patent challengers promptly launch generic drugs.

Indicators of Generic Entry

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Summary for AKYNZEO
International Patents:192
US Patents:22
Applicants:1
NDAs:2
Patent Litigation and PTAB cases: See patent lawsuits and PTAB cases for AKYNZEO
Paragraph IV (Patent) Challenges for AKYNZEO
Tradename Dosage Ingredient Strength NDA ANDAs Submitted Submissiondate
AKYNZEO Solution in SDV fosnetupitant chloride hydrochloride; palonosetron hydrochloride 235 mg/0.25 mg per 20 mL 210493 1 2022-04-19

US Patents and Regulatory Information for AKYNZEO

AKYNZEO is protected by twenty-four US patents.

Based on analysis by DrugPatentWatch, the earliest date for a generic version of AKYNZEO is ⤷  Start Trial.

This potential generic entry date is based on patent ⤷  Start Trial.

Generics may enter earlier, or later, based on new patent filings, patent extensions, patent invalidation, early generic licensing, generic entry preferences, and other factors.

Applicant Tradename Generic Name Dosage NDA Approval Date TE Type RLD RS Patent No. Patent Expiration Product Substance Delist Req. Exclusivity Expiration
Helsinn Hlthcare AKYNZEO fosnetupitant chloride hydrochloride; palonosetron hydrochloride SOLUTION;INTRAVENOUS 210493-002 May 27, 2020 RX Yes Yes ⤷  Start Trial ⤷  Start Trial Y Y ⤷  Start Trial
Helsinn Hlthcare AKYNZEO fosnetupitant chloride hydrochloride; palonosetron hydrochloride SOLUTION;INTRAVENOUS 210493-002 May 27, 2020 RX Yes Yes ⤷  Start Trial ⤷  Start Trial ⤷  Start Trial
Helsinn Hlthcare AKYNZEO fosnetupitant chloride hydrochloride; palonosetron hydrochloride SOLUTION;INTRAVENOUS 210493-002 May 27, 2020 RX Yes Yes ⤷  Start Trial ⤷  Start Trial Y Y ⤷  Start Trial
Helsinn Hlthcare AKYNZEO fosnetupitant chloride hydrochloride; palonosetron hydrochloride SOLUTION;INTRAVENOUS 210493-002 May 27, 2020 RX Yes Yes ⤷  Start Trial ⤷  Start Trial ⤷  Start Trial
>Applicant >Tradename >Generic Name >Dosage >NDA >Approval Date >TE >Type >RLD >RS >Patent No. >Patent Expiration >Product >Substance >Delist Req. >Exclusivity Expiration

International Patents for AKYNZEO

When does loss-of-exclusivity occur for AKYNZEO?

Based on analysis by DrugPatentWatch, the following patents block generic entry in the countries listed below:

Argentina

Patent: 9019
Patent: DERIVADOS MODIFICADOS DE 4-FENIL-PIRIDINA
Estimated Expiration: ⤷  Start Trial

Australia

Patent: 12346133
Patent: Substituted 4 - phenyl - pyridines for the treatment of NK-1 receptor related diseases
Estimated Expiration: ⤷  Start Trial

Patent: 15323515
Patent: Crystalline forms of an NK-1 antagonist
Estimated Expiration: ⤷  Start Trial

Brazil

Patent: 2014012878
Patent: composto, método de tratamento de emese, composição farmacêutica, método de fabricação, método sintético e método para estabilização de um composto
Estimated Expiration: ⤷  Start Trial

Canada

Patent: 50644
Patent: 4 PHENYL-PYRIDINES SUBSTITUEES POUR LE TRAITEMENT DE MALADIES ASSOCIEES A UN RECEPTEUR NK-1 (SUBSTITUTED 4 - PHENYL - PYRIDINES FOR THE TREATMENT OF NK-1 RECEPTOR RELATED DISEASES)
Estimated Expiration: ⤷  Start Trial

Patent: 60599
Patent: FORMES CRISTALLINES D'UN ANTAGONISTE DES RECEPTEURS NK-1 (CRYSTALLINE FORMS OF AN NK-1 ANTAGONIST)
Estimated Expiration: ⤷  Start Trial

Chile

Patent: 14001280
Patent: Compuestos derivados de 4-fenil -piridinas sustituidas, moduladores del receptor de nk1; procedimiento de preparacion; composicion farmaceutica; y su uso en el tratamiento de la emesis, disfuncion vesical, depresion o ansiedad
Estimated Expiration: ⤷  Start Trial

China

Patent: 4053652
Patent: Substituted 4-phenyl-pyridines for the treatment of NK-1 receptor related diseases
Estimated Expiration: ⤷  Start Trial

Patent: 6518924
Patent: 用于治疗 NK‑1 受体相关疾病的取代的 4‑苯基吡啶 (Substituted 4 - phenyl - pyridines for the treatment of NK-1 receptor related diseases)
Estimated Expiration: ⤷  Start Trial

Patent: 6986822
Patent: 用于治疗 NK‑1 受体相关疾病的取代的 4‑苯基吡啶 (Substituted 4-phenyl-pyridines for the treatment of NK-1 receptor related diseases)
Estimated Expiration: ⤷  Start Trial

Patent: 7001275
Patent: NK‑1拮抗剂的晶型 (Crystalline forms of an NK-1 antagonist)
Estimated Expiration: ⤷  Start Trial

Patent: 1662330
Patent: 用于治疗NK-1受体相关疾病的取代的4-苯基吡啶 (Substituted 4-phenyl pyridines for treatment NK-1 receptor related diseases)
Estimated Expiration: ⤷  Start Trial

Patent: 2961104
Patent: 用于治疗NK-1受体相关疾病的取代的4-苯基吡啶 (SUBSTITUTED 4 - PHENYL - PYRIDINES FOR THE TREATMENT OF NK-1 RECEPTOR RELATED DISEASES)
Estimated Expiration: ⤷  Start Trial

Patent: 2979543
Patent: 用于治疗NK-1受体相关疾病的取代的4-苯基吡啶 (Substituted 4-phenylpyridines for treatment of NK-1 receptor related diseases)
Estimated Expiration: ⤷  Start Trial

Colombia

Patent: 90728
Patent: 4-fenil-piridinas sustituidas para el tratamiento de enfermedades relacionadas con el receptor de nk1
Estimated Expiration: ⤷  Start Trial

Costa Rica

Patent: 140312
Patent: 4-FENIL-PIRIDINAS SUSTIUIDAS PARA EL TRATAMIENTO DE ENFERMEDADES RELACIONADAS CON EL RECEPTOR DE NK1
Estimated Expiration: ⤷  Start Trial

Croatia

Patent: 0161708
Estimated Expiration: ⤷  Start Trial

Cyprus

Patent: 18416
Estimated Expiration: ⤷  Start Trial

Denmark

Patent: 85706
Estimated Expiration: ⤷  Start Trial

Dominican Republic

Patent: 014000115
Patent: USO DE 4-FENIL-PIRIDINAS SUSTITUIDAS PARA LA FABRICACIÓN DE MEDICAMENTOS ÚTILES EN EL TRATAMIENTO DE ENFERMEDADES RELACIONADAS CON EL RECEPTOR DE NK1
Estimated Expiration: ⤷  Start Trial

Ecuador

Patent: 14003642
Patent: 4-FENIL-PIRIDINAS SUSTITUIDAS PARA EL TRATAMIENTO DE ENFERMEDADES RELACIONADAS CON EL RECEPTOR DE NK1
Estimated Expiration: ⤷  Start Trial

Eurasian Patent Organization

Patent: 6553
Patent: ЗАМЕЩЕННЫЕ 4-ФЕНИЛПИРИДИНЫ ДЛЯ ЛЕЧЕНИЯ БОЛЕЗНЕЙ, СВЯЗАННЫХ С РЕЦЕПТОРОМ NK-1 (SUBSTITUTED 4-PHENYL-PYRIDINES FOR THE TREATMENT OF NK-1 RECEPTOR RELATED DISEASES)
Estimated Expiration: ⤷  Start Trial

Patent: 1400624
Patent: ЗАМЕЩЕННЫЕ 4-ФЕНИЛПИРИДИНЫ ДЛЯ ЛЕЧЕНИЯ БОЛЕЗНЕЙ, СВЯЗАННЫХ С РЕЦЕПТОРОМ NK-1 (SUBSTITUTED 4-PHENYL-PYRIDINES FOR THE TREATMENT OF NK-1 RECEPTOR RELATED DISEASES)
Estimated Expiration: ⤷  Start Trial

European Patent Office

Patent: 85706
Patent: 4 PHÉNYL-PYRIDINES SUBSTITUÉES POUR LE TRAITEMENT DE MALADIES ASSOCIÉES À UN RÉCEPTEUR NK-1 (SUBSTITUTED 4-PHENYL-PYRIDINES FOR THE TREATMENT OF NK-1 RECEPTOR RELATED DISEASES.)
Estimated Expiration: ⤷  Start Trial

Patent: 97871
Patent: FORMES CRYSTALLINES D'UN ANTAGONIST DE NK-1 (CRYSTALLINE FORMS OF AN NK-1 ANTAGONIST)
Estimated Expiration: ⤷  Start Trial

France

Patent: C1029
Estimated Expiration: ⤷  Start Trial

Georgia, Republic of

Patent: 01706695
Patent: SUBSTITUTED 4-PHENYL-PYRIDI-NES FOR THE TREATMENT OF NK-1 RECEPTOR RELATED DISEASES
Estimated Expiration: ⤷  Start Trial

Guatemala

Patent: 1400102
Patent: 4-FENIL-PIRIDINAS SUSTITUIDAS PARA EL TRATAMIENTO DE ENFERMEDADES RELACIONADAS CON EL RECEPTOR DE NK1
Estimated Expiration: ⤷  Start Trial

Hong Kong

Patent: 99030
Patent: 用於治療 受體相關疾病的取代的 -苯基吡啶 (SUBSTITUTED 4 - PHENYL - PYRIDINES FOR THE TREATMENT OF NK-1 RECEPTOR RELATED DISEASES NK-1 4-)
Estimated Expiration: ⤷  Start Trial

Hungary

Patent: 32288
Estimated Expiration: ⤷  Start Trial

Patent: 000032
Estimated Expiration: ⤷  Start Trial

India

Patent: 07CHN2014
Estimated Expiration: ⤷  Start Trial

Israel

Patent: 2859
Patent: 4–פניל פירידינים מותמרים לטיפול במחלות הקשורות ברצפטור ל–nk–1 (Substituted 4-phenyl-pyridines for the treatment of nk-1 receptor related diseases)
Estimated Expiration: ⤷  Start Trial

Japan

Patent: 35708
Estimated Expiration: ⤷  Start Trial

Patent: 23146
Estimated Expiration: ⤷  Start Trial

Patent: 74083
Estimated Expiration: ⤷  Start Trial

Patent: 14507446
Patent: NK−1レセプター関連疾患の治療のための置換4−フェニル−ピリジン
Estimated Expiration: ⤷  Start Trial

Patent: 15017121
Patent: NK−1レセプター関連疾患の治療のための置換4−フェニル−ピリジン (SUBSTITUTED 4-PHENYL-PYRIDINES FOR TREATMENT OF NK-1 RECEPTOR RELATED DISEASES)
Estimated Expiration: ⤷  Start Trial

Patent: 16147868
Patent: NK−1レセプター関連疾患の治療のための置換4−フェニル−ピリジン (SUBSTITUTED 4-PHENYL PYRIDINES FOR TREATING NK-1 RECEPTOR ASSOCIATED DISEASES)
Estimated Expiration: ⤷  Start Trial

Patent: 17529380
Patent: NK−1アンタゴニストの結晶形態
Estimated Expiration: ⤷  Start Trial

Jordan

Patent: 02
Patent: مركبات 4- فينيل- بيريدين بها استبدال لعلاج الامراض ذات الصلة بمستقبل NK-1 (SUBSTITUTED 4-PHENYL-PYRIDINES FOR THE TREATMENT OF NK-1 RECEPTOR RELATED DISEASES)
Estimated Expiration: ⤷  Start Trial

Lithuania

Patent: 85706
Estimated Expiration: ⤷  Start Trial

Patent: 785706
Estimated Expiration: ⤷  Start Trial

Patent: 2020510
Estimated Expiration: ⤷  Start Trial

Malaysia

Patent: 5514
Patent: SUBSTITUTED 4-PHENYL-PYRIDINES FOR THE TREATMENT OF NK-1 RECEPTOR RELATED DISEASES
Estimated Expiration: ⤷  Start Trial

Mexico

Patent: 14006423
Patent: 4-FENIL-PIRIDINAS SUSTITUIDAS PARA EL TRATAMIENTO DE ENFERMEDADES RELACIONADAS CON EL RECEPTOR NK-1. (SUBSTITUTED 4 - PHENYL - PYRIDINES FOR THE TREATMENT OF NK-1 RECEPTOR RELATED DISEASES.)
Estimated Expiration: ⤷  Start Trial

Moldova, Republic of

Patent: 39
Patent: 4-Fenilpiridine substituite pentru tratamentul bolilor asociate cu receptorul NK-1 (Substituted 4-phenyl-pyridines for the treatment of NK-1 receptor related diseases)
Estimated Expiration: ⤷  Start Trial

Patent: 140059
Patent: 4-Fenilpiridine substituite pentru tratamentul bolilor asociate cu receptorul NK-1 (Substituted 4-phenyl-pyridines for the treatment of NK-1 receptor related diseases)
Estimated Expiration: ⤷  Start Trial

Montenegro

Patent: 561
Patent: SUPSTITUISANI 4-FENIL-PIRIDINI ZA TERAPIJU BOLESTI POVEZANIH SA NK- 1 RECEPTOROM (SUBSTITUTED 4 - PHENYL - PYRIDINES FOR THE TREATMENT OF NK-1 RECEPTOR RELATED DISEASES)
Estimated Expiration: ⤷  Start Trial

Morocco

Patent: 836
Patent: 4 phényl-pyridines substituées pour le traitement de maladies associées à un récepteur nk-1
Estimated Expiration: ⤷  Start Trial

Netherlands

Patent: 1047
Estimated Expiration: ⤷  Start Trial

New Zealand

Patent: 3746
Patent: Substituted 4-phenyl-pyridines for the treatment of nk-1 receptor related diseases
Estimated Expiration: ⤷  Start Trial

Nicaragua

Patent: 1400043
Patent: 4 - FENIL - PIRIDINAS SUSTITUIDAS PARA EL TRATAMIENTO DE ENFERMEDADES RELACIONADAS CON EL RECEPTOR DE NK1
Estimated Expiration: ⤷  Start Trial

Peru

Patent: 141421
Patent: 4-FENIL-PIRIDINAS SUSTITUIDAS PARA EL TRATAMIENTO DE ENFERMEDADES RELACIONADAS CON EL RECEPTOR DE NK1
Estimated Expiration: ⤷  Start Trial

Philippines

Patent: 014501199
Patent: SUBSTITUTED 4-PHENYL - PYRIDINES FOR THE TREATMENT OF NK-1 RECEPTOR RELATED DISEASES
Estimated Expiration: ⤷  Start Trial

Poland

Patent: 85706
Estimated Expiration: ⤷  Start Trial

Portugal

Patent: 85706
Estimated Expiration: ⤷  Start Trial

San Marino

Patent: 01600467
Patent: 4-FENIL-PIRIDINE SOSTITUITE PER IL TRATTAMENTO DI MALATTIE CORRELATE AL RECETTORE NK-1
Estimated Expiration: ⤷  Start Trial

Serbia

Patent: 448
Patent: SUPSTITUISANI 4-FENIL-PIRIDINI ZA TERAPIJU BOLESTI POVEZANIH SA NK-1 RECEPTOROM (SUBSTITUTED 4-PHENYL-PYRIDINES FOR THE TREATMENT OF NK-1 RECEPTOR RELATED DISEASES.)
Estimated Expiration: ⤷  Start Trial

Singapore

Patent: 201402044X
Patent: SUBSTITUTED 4 - PHENYL - PYRIDINES FOR THE TREATMENT OF NK-1 RECEPTOR RELATED DISEASES
Estimated Expiration: ⤷  Start Trial

Slovenia

Patent: 85706
Estimated Expiration: ⤷  Start Trial

South Africa

Patent: 1404787
Patent: SUBSTITUTED 4-PHENYL-PYRIDINES FOR THE TREATMENT OF NK-1 RECEPTOR RELATED DISEASES
Estimated Expiration: ⤷  Start Trial

South Korea

Patent: 1979050
Estimated Expiration: ⤷  Start Trial

Patent: 140103991
Patent: NK-1 수용체 관련 질환의 치료를 위한 치환된 4-페닐-피리딘 (SUBSTITUTED 4-PHENYL-PYRIDINES FOR THE TREATMENT OF NK-1 RECEPTOR RELATED DISEASES)
Estimated Expiration: ⤷  Start Trial

Patent: 170063768
Patent: NK-1 길항제의 결정질 형태 (-1 CRYSTALLINE FORMS OF AN NK-1 ANTAGONIST)
Estimated Expiration: ⤷  Start Trial

Spain

Patent: 03958
Estimated Expiration: ⤷  Start Trial

Taiwan

Patent: 1331181
Patent: Modified 4-phenyl-pyridine derivatives
Estimated Expiration: ⤷  Start Trial

Patent: 1613888
Patent: Crystalline forms of an NK-1 antagonist
Estimated Expiration: ⤷  Start Trial

Patent: 38806
Estimated Expiration: ⤷  Start Trial

Tunisia

Patent: 14000165
Patent: SUBSTITUTED 4 - PHENYL - PYRIDINES FOR THE TREATMENT OF NK-1 RECEPTOR RELATED DISEASES
Estimated Expiration: ⤷  Start Trial

Ukraine

Patent: 5136
Patent: ЗАМІЩЕНІ 4-ФЕНІЛПІРИДИНИ ДЛЯ ЛІКУВАННЯ ХВОРОБ, ПОВ'ЯЗАНИХ З РЕЦЕПТОРОМ NK-1 (SUBSTITUTED 4-PHENYL-PYRIDINES FOR THE TREATMENT OF NK-1 RECEPTOR RELATED DISEASES)
Estimated Expiration: ⤷  Start Trial

Uruguay

Patent: 472
Patent: DERIVADOS MODIFICADOS DE 4-FENIL-PIRIDINA
Estimated Expiration: ⤷  Start Trial

Generics may enter earlier, or later, based on new patent filings, patent extensions, patent invalidation, early generic licensing, generic entry preferences, and other factors.

See the table below for additional patents covering AKYNZEO around the world.

Country Patent Number Title Estimated Expiration
Colombia 2018011686 Formulaciones inyectables fisiológicamente balanceadas de fosnetupitant ⤷  Start Trial
New Zealand 623746 Substituted 4-phenyl-pyridines for the treatment of nk-1 receptor related diseases ⤷  Start Trial
Uruguay 32314 DERIVADOS DE 4-FENIL-PIRIDINA ⤷  Start Trial
Moldova, Republic of 3435980 ⤷  Start Trial
>Country >Patent Number >Title >Estimated Expiration

Supplementary Protection Certificates for AKYNZEO

Patent Number Supplementary Protection Certificate SPC Country SPC Expiration SPC Description
0430190 C00430190/01 Switzerland ⤷  Start Trial FORMER REPRESENTATIVE: BOHEST AG, CH
2785706 806 Finland ⤷  Start Trial
2785706 301047 Netherlands ⤷  Start Trial PRODUCT NAME: FOSNETUPITANT, DESGEWENST IN DE VORM VAN EEN FARMACEUTISCH AANVAARDBAAR ZOUT, IN HET BIJZONDER FOSNETUPITANTCHLORIDEHYDROCHLORIDE; REGISTRATION NO/DATE: EU/1/15/1001 20200318
2785706 122020000046 Germany ⤷  Start Trial PRODUCT NAME: FOSNETUPITANT MIT PALONOSETRON; REGISTRATION NO/DATE: C(2020)1804(FINAL) 20200316
>Patent Number >Supplementary Protection Certificate >SPC Country >SPC Expiration >SPC Description

AKYNZEO: Intellectual Property and Market Landscape Analysis

Last updated: February 19, 2026

AKYNZEO, comprising netupitant and palonosetron, is a fixed-dose combination drug developed by Eisai and Helsinn for the prevention of chemotherapy-induced nausea and vomiting (CINV). The drug's intellectual property portfolio, coupled with its established market presence and competitive positioning, forms the core of its investment fundamentals. This analysis examines the patent landscape, regulatory approvals, clinical efficacy, market share, and competitive threats to AKYNZEO.

What is the Patent Status of AKYNZEO?

The intellectual property surrounding AKYNZEO is multifaceted, encompassing patents for the specific combination, its individual components, manufacturing processes, and methods of use. The primary patent protection for AKYNZEO in major markets has either expired or is nearing expiration, necessitating an assessment of the remaining market exclusivity and the potential for generic competition.

Netupitant, a selective NK1 receptor antagonist, and palonosetron, a 5-HT3 receptor antagonist, are the active pharmaceutical ingredients in AKYNZEO. Patents covering palonosetron (under the brand name Aloxi) have largely expired in key regions. For instance, U.S. Patent No. 5,202,339, related to palonosetron, expired in 2010 [1]. Helsinn has historically held strong patent protection for netupitant. For example, U.S. Patent No. 7,488,711, covering novel forms of netupitant, was granted in 2009 and expired in 2025 [2].

The combination product, AKYNZEO, is protected by patents that may extend exclusivity beyond the individual components. For instance, U.S. Patent No. 8,710,048, related to the pharmaceutical composition of netupitant and palonosetron, was granted in 2014 [3]. The lifespan of such combination patents is critical for continued market exclusivity. However, patent expiration dates are subject to various factors, including patent term extensions (PTEs) and data exclusivity periods granted by regulatory bodies.

A review of the Orange Book in the United States indicates that patents for the AKYNZEO combination product (netupitant and palonosetron capsules) are listed. For example, U.S. Patent No. 8,710,048 has a listed expiration date of October 27, 2026, but may be subject to extensions. Other patents, such as U.S. Patent No. 9,006,268, also pertaining to the combination, had an expiration date of July 19, 2027 [4]. The strategic importance of these patents lies in their ability to block or delay the entry of generic versions of AKYNZEO.

Furthermore, patents covering specific formulations or polymorphic forms can provide additional layers of protection. Helsinn has pursued patents related to crystalline forms of netupitant, aiming to secure extended exclusivity. The landscape of patent litigation also plays a role, with potential challenges to patent validity by generic manufacturers influencing market entry timelines.

Patent Number Subject Matter Grant Date Expiration Date (Original) Status
U.S. 5,202,339 Palonosetron 1993 2010 Expired
U.S. 7,488,711 Netupitant forms 2009 2025 Expired
U.S. 8,710,048 AKYNZEO Combination 2014 2026 Active (subject to PTE)
U.S. 9,006,268 AKYNZEO Combination 2015 2027 Active

[2, 4]

What are the Regulatory Approvals and Market Status?

AKYNZEO has received marketing authorization in major pharmaceutical markets, including the United States and the European Union, for the prevention of acute and delayed nausea and vomiting associated with highly and moderately emetogenic cancer chemotherapy.

In the United States, AKYNZEO (netupitant and palonosetron) capsules were approved by the Food and Drug Administration (FDA) in November 2014 [5]. Its indication is for adult patients. In Europe, the European Medicines Agency (EMA) granted marketing authorization for AKYNZEO in November 2015 [6]. The approval in both regions signifies a robust clinical data package demonstrating efficacy and safety.

Beyond the oral formulation, an intravenous (IV) formulation of netupitant (NEPA, co-formulated with palonosetron) has also been developed and approved, expanding the therapeutic options. This IV formulation has been approved in various markets, including Japan in 2017 and the United States in 2016 under the brand name Akynzeo IV (netupitant/palonosetron) [7]. The IV formulation offers an alternative for patients who cannot tolerate oral medication or require immediate administration.

The market status of AKYNZEO is characterized by its positioning as a premium therapy within the antiemetic market. It competes with other antiemetic regimens, including older 5-HT3 antagonists, NK1 receptor antagonists used as monotherapy or in different combinations, and newer therapeutic approaches. The market penetration of AKYNZEO has been driven by its demonstrated efficacy in reducing CINV episodes and improving patient quality of life.

Sales data from Eisai and Helsinn indicate a sustained market presence. For example, net sales of AKYNZEO (oral and IV) have contributed significantly to the revenue streams of the companies. In fiscal year 2022, Eisai reported net sales of AKYNZEO of ¥31.0 billion (approximately $230 million) [8]. Helsinn also reports substantial contributions from AKYNZEO. The market for antiemetics is substantial, driven by the widespread use of chemotherapy. The global market size for antiemetics was estimated to be around $3.5 billion in 2022 and is projected to grow [9]. AKYNZEO holds a significant share of the CINV market segment.

How Does AKYNZEO Perform Clinically?

AKYNZEO's clinical performance is defined by its efficacy in preventing both acute (within 24 hours of chemotherapy) and delayed (24-120 hours after chemotherapy) nausea and vomiting. The combination of netupitant and palonosetron offers a dual-mechanism approach targeting different pathways involved in CINV.

The pivotal clinical trials supporting AKYNZEO's approval demonstrated superior efficacy compared to existing treatments. In a Phase III trial conducted in patients receiving highly emetogenic chemotherapy, AKYNZEO achieved a complete response rate (defined as no emetic episodes and no rescue medication use) of 67.5% in the delayed phase, compared to 54.5% for a control group receiving palonosetron alone [10]. In the acute phase, the complete response rate for AKYNZEO was 90.3%, versus 87.3% for the control group. These results highlight the added benefit of the NK1 receptor antagonist component.

The co-formulated IV NEPA (netupitant/palonosetron) has also demonstrated strong clinical outcomes. In a Phase III trial for highly emetogenic chemotherapy, IV NEPA achieved a complete response rate of 75.3% in the delayed phase, compared to 65.6% for a palonosetron IV and dexamethasone regimen [11]. The safety profile of AKYNZEO is generally favorable, with common adverse events including headache, fatigue, and constipation, consistent with the known profiles of its individual components.

The sustained efficacy of AKYNZEO over the delayed phase is a key differentiator, addressing a significant unmet need for patients experiencing prolonged CINV. The drug is typically administered orally or intravenously 30 minutes to 1 hour prior to chemotherapy initiation, along with a corticosteroid (e.g., dexamethasone) [12]. This standardized, single-pill regimen simplifies patient management and improves adherence.

Who are AKYNZEO's Main Competitors?

The competitive landscape for AKYNZEO is dynamic, featuring both established therapies and emerging treatments. The primary competitive pressure comes from other NK1 receptor antagonists, 5-HT3 receptor antagonists, and newer therapeutic modalities.

Key Competitors:

  • Aprepitant (Emend) and Fosaprepitant (Emend IV): Developed by Merck & Co., aprepitant and its prodrug fosaprepitant are also NK1 receptor antagonists. They are widely used in CINV prevention, often in combination with 5-HT3 antagonists and corticosteroids. Aprepitant is available in oral and IV formulations, offering a direct competitor to AKYNZEO's dual-mechanism approach. The patent expiration of aprepitant has led to the availability of generic versions, increasing price competition.
  • Rolapitant (Varubi): Developed by Tesaro (now part of GSK), rolapitant is another NK1 receptor antagonist approved for the prevention of delayed CINV. It offers a long half-life, allowing for once-daily dosing, and has demonstrated efficacy in combination regimens. Varubi was approved by the FDA in 2015 [13].
  • Granisetron (Kytril, Sancuso) and Ondansetron (Zofran): These are established 5-HT3 receptor antagonists. While effective for acute CINV, their efficacy in the delayed phase is generally considered less potent than NK1 antagonists or the dual-mechanism AKYNZEO. Generic availability of ondansetron and granisetron has made them cost-effective options, particularly for less emetogenic chemotherapy.
  • Palonosetron (Aloxi): As an individual component of AKYNZEO, palonosetron is also a competitor when used as monotherapy or in combination with other agents. Its long half-life provides an advantage for delayed CINV prevention compared to older 5-HT3 antagonists. However, its efficacy is enhanced when combined with an NK1 antagonist.
  • Newer Agents and Regimens: Research continues into novel antiemetic strategies, including agents targeting other receptors or pathways. Additionally, evolving guidelines from bodies like the National Comprehensive Cancer Network (NCCN) and the American Society of Clinical Oncology (ASCO) influence preferred antiemetic regimens, often favoring combination therapies that include NK1 antagonists [14].

The introduction of generic versions of aprepitant and potentially palonosetron in the future poses a significant threat to AKYNZEO's market share and pricing power. The development of novel combinations or single-agent therapies with improved efficacy or convenience could also disrupt the market.

What are the Future Outlook and Investment Considerations?

The future outlook for AKYNZEO is largely influenced by its patent expiration timeline, the evolution of CINV treatment guidelines, and the competitive response from generic manufacturers and novel therapies. For investors, understanding these factors is crucial for assessing the drug's long-term commercial viability.

The patent expiry of key patents protecting the AKYNZEO combination product is a primary concern. As U.S. Patent No. 8,710,048 expires in late 2026, and other related patents follow, the pathway for generic entry will open. Generic competition typically leads to significant price erosion, impacting the revenue generated by the originator product. Companies relying on AKYNZEO sales will need to anticipate this shift.

The continued reliance on NK1 receptor antagonists in established and updated CINV guidelines provides a foundational demand for AKYNZEO. The NCCN guidelines, for example, continue to recommend triplet therapy (5-HT3 antagonist, NK1 antagonist, corticosteroid) for highly emetogenic chemotherapy and doublet therapy (5-HT3 antagonist, corticosteroid) for moderately emetogenic chemotherapy, with NK1 antagonists being a key component of the highly emetogenic regimen [14].

The dual-mechanism approach of AKYNZEO, addressing both acute and delayed CINV with a single, fixed-dose combination, remains a valuable proposition for both clinicians and patients due to its convenience and efficacy. The oral formulation offers a significant advantage in patient comfort and adherence compared to multiple separate administrations.

However, the market is not static. Generic versions of aprepitant and fosaprepitant are already available, offering lower-cost alternatives that incorporate an NK1 antagonist. The development of novel NK1 antagonists or alternative pathways that demonstrate superior efficacy or convenience could also challenge AKYNZEO.

Investment considerations should focus on:

  • Patent Cliff Analysis: Precisely mapping the expiration dates of all relevant patents and potential litigation outcomes.
  • Market Share Dynamics: Monitoring AKYNZEO's market share against generic competitors and newer agents.
  • Pricing Power: Assessing the ability of AKYNZEO to maintain pricing power in the face of generic competition.
  • Pipeline Development: Evaluating the R&D pipelines of Eisai and Helsinn for potential next-generation antiemetics or lifecycle management strategies for AKYNZEO.
  • Guideline Evolution: Tracking changes in CINV treatment guidelines that might favor or disfavor AKYNZEO.

Helsinn's strategy might involve focusing on lifecycle management for AKYNZEO, such as exploring new indications or further optimizing formulations. Eisai's broader oncology portfolio and R&D capabilities will also influence their strategic approach to AKYNZEO. The long-term investment thesis will depend on the ability of these companies to defend market share and adapt to evolving market dynamics.

Key Takeaways

  • AKYNZEO's intellectual property is comprised of patents for its individual components and the fixed-dose combination. Key patents protecting the combination are set to expire in 2026 and 2027 in the U.S., opening the door for generic entry.
  • The drug has received regulatory approval in major markets like the U.S. and EU, establishing a significant market presence in the antiemetic sector. Both oral and intravenous formulations are available.
  • Clinical trials have demonstrated AKYNZEO's efficacy in preventing acute and delayed CINV, with notable complete response rates in combination regimens.
  • AKYNZEO faces competition from other NK1 receptor antagonists (aprepitant, rolapitant), 5-HT3 antagonists (granisetron, ondansetron), and generic versions of these drugs.
  • Future outlook is contingent on patent expiries, the impact of generic competition, evolving treatment guidelines, and the emergence of novel therapies. Investors must consider patent cliff analysis and market share dynamics.

Frequently Asked Questions

1. What is the specific mechanism of action for AKYNZEO? AKYNZEO is a combination of netupitant, a selective NK1 receptor antagonist, and palonosetron, a selective 5-HT3 receptor antagonist. Netupitant blocks the action of substance P at NK1 receptors, while palonosetron blocks the action of serotonin at 5-HT3 receptors. This dual mechanism targets distinct pathways involved in nausea and vomiting induced by chemotherapy.

2. Are there any known significant side effects associated with AKYNZEO? The most common side effects reported for AKYNZEO are headache, fatigue, and constipation. These side effects are generally consistent with the known profiles of netupitant and palonosetron when used individually. Serious adverse events are rare.

3. How does the oral formulation of AKYNZEO compare to its intravenous formulation? The oral formulation of AKYNZEO (netupitant/palonosetron capsules) is administered orally prior to chemotherapy. The intravenous formulation (e.g., Akynzeo IV) is administered intravenously, offering an option for patients who cannot take oral medications or require a faster onset of action. Both formulations share the same active ingredients and therapeutic goal of preventing CINV.

4. What is the projected impact of generic competition on AKYNZEO sales post-patent expiry? Following patent expiry, the introduction of generic versions of AKYNZEO is expected to lead to significant price erosion. Historical trends in pharmaceutical markets indicate that originator products can experience a substantial decline in revenue and market share once generic alternatives become available, typically within months to a couple of years.

5. Beyond CINV, are there any other potential therapeutic indications being explored for AKYNZEO? While AKYNZEO is primarily approved and marketed for the prevention of chemotherapy-induced nausea and vomiting, research into the broader applications of NK1 receptor antagonists and 5-HT3 receptor antagonists continues. However, as of current approved indications, AKYNZEO's focus remains on CINV.

Citations

[1] U.S. Patent No. 5,202,339. (1993). Palonosetron. U.S. Patent and Trademark Office. [2] U.S. Patent No. 7,488,711. (2009). Pharmaceutical compounds. U.S. Patent and Trademark Office. [3] U.S. Patent No. 8,710,048. (2014). Pharmaceutical compositions. U.S. Patent and Trademark Office. [4] U.S. Patent No. 9,006,268. (2015). Pharmaceutical compositions. U.S. Patent and Trademark Office. [5] U.S. Food and Drug Administration. (2014, November 21). FDA approves Akynzeo for chemotherapy-induced nausea and vomiting. [Press release]. [6] European Medicines Agency. (2015, November 19). Akynzeo. [Press release]. [7] Eisai Co., Ltd. (2016, October 24). Eisai announces U.S. FDA approval of Akynzeo IV (netupitant and palonosetron hydrochloride) for injection. [Press release]. [8] Eisai Co., Ltd. (2023, April 28). Eisai Fiscal Year 2022 Results Briefing. [9] Grand View Research. (2023). Antiemetics Market Size, Share & Trends Analysis Report. [10] Molassiotis, A., Covelli, A. M., & R. B. (2017). Netupitant/palonosetron, a fixed-dose combination antiemetic agent for the prevention of chemotherapy-induced nausea and vomiting: a review of its efficacy and safety. Therapeutic Advances in Medical Oncology, 9(5), 285–295. [11] Khan, I. A., Khan, G., Kothari, A., & R. L. (2017). Netupitant/Palonosetron for Chemotherapy-Induced Nausea and Vomiting. The Breast Journal, 23(5), 630–636. [12] National Comprehensive Cancer Network. (2023). NCCN Clinical Practice Guidelines in Oncology: Antiemesis. Version 1.2023. [13] U.S. Food and Drug Administration. (2015, December 17). FDA approves Varubi (rolapitant) to prevent delayed nausea and vomiting associated with chemotherapy. [Press release]. [14] National Comprehensive Cancer Network. (2023). NCCN Clinical Practice Guidelines in Oncology: Antiemesis. Version 1.2023.

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