Eli Lilly tipped to leapfrog Eisai, Biogen and take control of $13B Alzheimer's market

07 Jun 2024
www.fiercepharma.com
Drug ApprovalBiosimilar
Eli Lilly tipped to leapfrog Eisai, Biogen and take control of $13B Alzheimer's market
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Source: FiercePharma
Bloomberg Intelligence analysts expect Eisai, Biogen and Lilly to account for most Alzheimer’s disease sales in 2030.
Eisai and Biogen’s reign at the top of the Alzheimer’s disease market may be short-lived. While Leqembi is the only game in town today, Bloomberg Intelligence (BI) analysts expect Eli Lilly to come from behind and capture half of a $13 billion market by 2030.
Eisai and Biogen broke new ground with their anti-amyloid-beta antibody Leqembi and, after a sluggish start, are starting to talk more confidently about the drug’s growth trajectory. In May, Eisai tipped sales to rise to around $364 million in its 2024 fiscal year, which ends in March 2025. Yet, BI analysts predict the first-mover advantage will fail to secure Leqembi’s spot at the top of the sales chart in the long term.
“If approved, sales of [Lilly’s Alzheimer’s candidate] donanemab could exceed Leqembi's in 12 months, in part due to more convenient dosing and because patients can stop receiving the drug once amyloid levels reach a clearance threshold,” the analysts wrote.
Subjects in Lilly’s trial stopped taking donanemab when they passed amyloid negativity thresholds. An advisory committee is set to discuss the merits of the approach Monday, informed by FDA briefing documents that noted uncertainty created by the lack of an arm with continuous donanemab dosing and questions about the optimal thresholds.
Writing before the publication of the briefing documents, BI analysts predicted Lilly will be the dominant force in Alzheimer’s in 2030. Donanemab and its self-injected sibling remternetug could generate $6.5 billion in 2030, the analysts said, more than twice as much as the $3.2 billion forecast for Leqembi.
BI’s risk-adjusted scenario analysis for Leqembi puts sales 26% below the consensus for 2030. The $3.2 billion forecast is also well below the expectations of EisaiEisai, which has predicted Leqembi sales will climb to almost $9 billion by 2032. Eisai’s forecast includes some sales in preclinical Alzheimer’s, and BI noted sales would be much higher than its estimates if companies expand into the asymptomatic population.
While the analysts expect Eisai, Biogen and Lilly to account for most Alzheimer’s sales in 2030, they said companies with molecules currently in development could be generating around $3 billion a year by the end of the decade.
The analysts named AC Immune, Alzheon, Cassava Sciences and Vivoryon Therapeutics as companies with a shot at generating Alzheimer’s revenues in 2030. And the limited, albeit statistically significant, impact of Leqembi and donanemab on cognition leaves room for companies to leapfrog the incumbents.
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