Migraine Prevention - One Less Headache
A new class of migraine drugs are on the horizon after two successful phase 3 trials by Amgen/Novartis. We hosted a NSR roundtable with our migraine expert to help understand the potential of these drugs given that many of the current treatments are being used off-label and the dearth of new drugs over the past 10 years. We show that Novartis could generate $1bn in sales by 2021 but that the US potential could be significantly curtailed due to the highest prevalence in those least able to pay.AMGN/NOVN & LLY Lead the pack – Teva and Alder lag. We have already seen very promising P3 data from Amgen/Novartis in episodic migraine and phase 2b data in the larger Chronic Migraine indication (>15 headache days/mth). Novartis have ex-US rights to AMG334 (ex-Japan & Canada).
Large European Patient Population – We estimate there are 1.8m Chronic Migraine (CM) pts in Europe and show evidence that 55% of patients are uncontrolled on current therapies giving an available CM population of 990k for the CGRP’s. We also estimate ~800k Episodic Migraine pts seeking treatment in Europe.
Novartis to Benefit from $1.35bn peak sales – We forecast ~$300m peak sales in Episodic Migraine from 2018 and we model ~$1bn peak sales in Chronic Migraine from 2019. We forecast 2021 sales of $1bn assuming an ex-US price of $7000/pt/yr.
US Patient Access to be Limited – Amgen may look to cap the budget impact for payors. To do this we believe they will target private plans for wealthier households. We show that by limiting access to households where income exceeds $60k and private health insurance coverage is ~70%, Amgen would only be able to address around 30% of the total migraine patients because of the significantly higher prevalence in poorer households.
Novartis is a multinational healthcare group based in Switzerland. Co. provides healthcare solutions that address the evolving needs of patients and societies worldwide. Co.'s broad portfolio includes innovative medicines, eye care products and cost-saving generic pharmaceuticals. Co.'s operations are organized along three operating divisions: Innovative Medicines Division; Sandoz Division; and Alcon Division. Co.'s operations are supported by the Novartis Institutes for BioMedical Research and Novartis Business Services.
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