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Can there be another Keytruda?

Merck CEO Rob Davis, whose company makes the $25 billion-a-year cancer medicine, says it’s a “once-in-a-lifetime drug” whose success won’t be repeated.

“I can tell you at Merck, we’re not out there saying, ‘Let’s find the next Keytruda,’” Davis said at a PhRMA event on the sidelines of this year’s American Society of Clinical Oncology conference. “That was lightning in a bottle. Thank God we found it. The benefit it is having for cancer patients is phenomenal, but it is not a repeatable model.”

The immunotherapy drug will mark the 10-year anniversary of its first approval in September. It’s since been approved for a total of 39 indications across 17 different tumor types. Davis said Merck has spent about $46 billion to date developing the treatment and will spend almost another $20 billion by 2030 as it tests the drug in a wide range of combination studies.

“The future is less monolithic Keytruda,” Davis said. “It’s going to be a lot of smaller, precision-based therapies aimed at specific tumors or indications.”

Davis blamed the Inflation Reduction Act, which drug CEOs have repeatedly said will curtail the development of medicines.

“I worry that with the IRA and the incentives it puts in place, I’m not sure we would have developed Keytruda the same way we did if we were starting today,” he said.

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