Neurologists are thinking about Biogen’s newly approved Alzheimer’s drug, but so far it’s mostly just that—thoughts.
While almost 90% of neurologists are moderately or highly aware of Aduhelm, only 3% have written prescriptions so far, according to Spherix Global Insights latest data. Even more concerning? Only about one fourth (27%) plan to prescribe the drug in the next few months.
Typically that percentage would be much higher, especially for a first-in-class disease-modifying therapy, Virginia Schobel, Spherix’s neurology franchise head, said.
Spherix tracked the Aduhelm sentiment through its launch assessment system using physician data and interviews from June 30 through July 6. That was just days before the FDA narrowed Aduhelm’s label to early-stage patients. However it was clear even before this latest FDA label decision that neurologists themselves were narrowing the field, reporting they felt on average only one in seven Alzheimer’s patients, or about 14%, would be appropriate candidates for the drug.
“Instead of saying ‘OK first disease-modifying therapy for Alzheimer’s, I’m going to prescribe it to 100% of my Alzheimer’s patients,’ they are already saying ‘If it’s going to be difficult for me to start (a patient) on this therapy, who are the patients who really may benefit from it?’ ” she said.
Another potential sticking point? A full 18% of neurologists say they will “never” prescribe it. That tracks with other sentiments about Aduhelm as a scientific advancement, with only 34% of neurologists saying it represents a substantial advance, while 22% say it’s not an advance at all.
Schobel plans to watch the never-prescribers' percentage over time for changes, up or down. As she said, it's already "high out of the gate for a new product."
Even Biogen's launch is getting unenthusiastic reviews. While more than half have seen or spoken to a Biogen rep about Aduhelm, just 15% of neurologists rated the launch as excellent. Again, that’s low compared to other recently launched drugs such as Biohaven’s migraine drug Nurtec won its second approval and a 40% excellent rating, and Novartis’ MS med Kesimpta which launched during the pandemic and nabbed a 43% excellent launch rating from neurologists.
It’s especially low in this case because neurologists are familiar with Biogen from its multiple sclerosis' drugs such as Tecfidera and Vumerity, and as Schobel joked “usually Biogen can't really do anything wrong when it comes to neurology with them.”
With signs pointing to a lackluster or even just a slow start among neurologists, patients will likely drive prescriptions for now.
For neurologists who are comfortable prescribing Aduhelm, Schobel said she thinks "the initial use over this summer and fall is going to be driven by patient requests."