Eli Lilly poised to dominate $13B Alzheimer's market over Eisai, Biogen

Eisai, and Biogen have made significant strides with their anti-amyloid-beta antibody drug, Leqembi, emerging as a crucial player in the Alzheimer's disease market. Bloomberg Intelligence (BI) analysts, however, suggest that this dominance may be temporary. Despite Leqembi's current exclusivity, Eli Lilly is anticipated to overtake the market, potentially holding half of a projected $13 billion market by 2030.

Leqembi's Early Success and Challenges

Eisai and Biogen's Leqembi has been a trailblazer in Alzheimer's treatment, but its future market position is uncertain. With a projected sales increase to approximately $364 million in the fiscal year ending March 2025, Eisai is optimistic about Leqembi's growth. Nonetheless, BI analysts foresee that this initial advantage may not secure a long-term leading position for Leqembi.

Lilly's Potential Breakthrough

Eli Lilly’s Alzheimer’s candidate, donanemab, is poised to challenge Leqembi's dominance. If approved, donanemab’s sales could surpass those of Leqembi within a year. Factors contributing to this potential success include more convenient dosing schedules and the ability for patients to discontinue the drug once amyloid levels are adequately reduced. In clinical trials, participants stopped taking donanemab upon reaching specific amyloid negativity thresholds.

An upcoming advisory committee meeting will evaluate the merits of donanemab’s dosing strategy, influenced by FDA briefing documents that highlight uncertainties and optimal threshold questions. Despite these uncertainties, BI analysts are confident that Lilly will become the leading force in the Alzheimer’s market by 2030. They predict that donanemab and its self-injected variant, remternetug, could generate combined sales of $6.5 billion, considerably outpacing Leqembi's forecasted $3.2 billion.

Sales Projections and Market Dynamics

BI’s risk-adjusted analysis projects Leqembi’s 2030 sales to be 26% below consensus estimates, significantly lower than Eisai’s optimistic $9 billion sales forecast by 2032. Eisai’s higher estimates include anticipated sales in preclinical Alzheimer’s stages, suggesting that actual figures could exceed BI’s projections if the drug expands into asymptomatic populations.

Emerging Competitors

While Eisai, Biogen, and Lilly are expected to dominate the Alzheimer's market in 2030, other companies are also making significant progress. BI analysts highlight AC Immune, Alzheon, Cassava Sciences, and Vivoryon Therapeutics as potential contenders, with the capacity to generate around $3 billion annually by the end of the decade.

The effectiveness of Leqembi and donanemab in improving cognitive functions has been modest but statistically significant. This leaves an opportunity for emerging companies to potentially surpass current leaders in the Alzheimer's treatment landscape.

Conclusion

In summary, while Eisai and Biogen have made notable advancements with Leqembi, the future of the Alzheimer's market points towards a more competitive landscape. Eli Lilly is positioned to become a dominant player by 2030, with its candidates showing promising potential. Concurrently, other biotech firms are developing innovative treatments that could reshape the market dynamics, ensuring that the battle for leadership in Alzheimer’s treatment will continue to evolve.

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