Biohaven Pharmaceuticals has been offering early looks at the performance of its closely watched migraine drug launch since the fourth quarter of 2020. So, when the company recently stopped the practice of issuing preliminary results, investors started to worry.
In a note last Thursday, Piper Sandler analyst Christopher Raymond said his team has fielded “numerous calls” from Biohaven investors who voiced concern that something may be amiss with Nurtec ODT, the company’s sole commercial product. Shareholders speculated that demand for the oral CGRP migraine drug might have declined or that its net price might have come under pressure, the analyst wrote.
Biohaven’s stock price dropped as much as 19% in April as the absence of the preliminary report seemed to dampen investor confidence. But in a statement to Fierce Pharma, Biohaven said it only intended to release unofficial earnings preannouncements early in the Nurtec launch.
“We previously communicated that in our first full year of launch (2021) we thought it was important to efficiently release our revenues numbers before our comprehensive earnings release but that would change in subsequent reporting periods. That did not establish a long-term pre-release policy for subsequent years,” Biohaven said.
Nurtec got its initial FDA nod for acute treatment of migraine in February 2020. In May 2021, the drug added an indication for preventive treatment of episodic migraine.
In the absence of a preliminary report, analysts have been busy digging into doctor feedback and prescription numbers. The finding? Investors don’t have to panic, but there’s reason to have conservative expectations.
Nurtec has grown its scripts by 8% in the first quarter over the previous three months, analysts at SVB Securities said in a note last Thursday. Based on the number, the team increased its Nurtec sales estimate to $180 million in the first quarter of 2022 from a prior projection of $172 million. The analysts expect full-year sales of $926 million, a slight increase from their prior projection of $901 million.
Still, the $180 million projection from SVB Securities for the first quarter marks a step down from the drug’s $190 million sales in the fourth quarter of 2021. It also comes below current Wall Street consensus. The key difference likely lies in uncertainties regarding Nurtec’s gross-to-net pricing ratio, which SVB Securities said “will continue to be a key variable that could drive volatility between forecasts and reported sales.”
Wary of potential meaningful net price pressure and “typical first-quarter headwinds,” Raymond also projected a sequential sales decline for Nurtec to $171 million in the first quarter.
But market share trends appear promising for Nurtec.
Citing a survey of neurologists conducted by Spherix Global Insights, Raymond noted that Nurtec’s share in acute migraine treatment has grown from 15% in the fourth quarter of 2021 to 17% in the first three months of 2022. That figure is expected to reach 19.3% by the third quarter.
In the prevention setting, Nurtec’s share has risen to 11% in the first quarter from 8% in the fourth quarter of 2021, the analyst wrote. By the third quarter this year, Nurtec's prevention share could further increase to 14%.
In the primary care setting, the survey results showed a preference for Nurtec and positive projections that were “even more pronounced,” Raymond said. For both primary care doctors and neurology specialists, Nurtec has maintained a share lead over AbbVie’s rival migraine franchise across acute and prevention settings.
Biohaven has yet to reveal when it plans to announce its first-quarter results.