There’s plenty of growth ahead for the CGRP class of migraine meds, according to analysts at Evercore ISI who recently surveyed 25 neurologists. And with two of the most promising drugs in the class, that’s good news for AbbVie.
AbbVie predicts Ubrelvy, a pill taken for acute relief from migraine attacks, and Qulipta, a pill to prevent attacks, will each generate peak sales of more than $1 billion. But Evercore’s survey of 25 neurologists indicates that AbbVie’s estimates might be conservative for the drugs, which the company gained in its 2020 acquisition of Allergan.
“It seems to us that peak sales potential for each could be closer to $2 billion-plus, instead of $1 billion," Evercore’s Josh Schimmer wrote in a note to investors.
Still, Biohaven’s Nurtec ODT represents a formidable competitor because it's endorsed both to treat and prevent migraine attacks. While Evercore sees Ubrelvy’s share of the CGRP acute market falling from 38% to 31%—largely thanks to gains made by Nurtec—the analysts say there is enough momentum for the class overall to benefit both players.
Evercore cites Biohaven’s pre-announced fourth quarter sales of $190 million, a 40% increase from the third quarter, as evidence of a “robust outlook for the CGRP class.”
Over the next five years, Evercore projects the use of CGRP drugs in the acute setting to grow by 200%. In the preventative setting, the analysts believe the CGRP growth will be 150% over the same period.
In the preventative arena, Qulipta’s share of the market will grow to between 9% and 18% of the market. That field is presently ruled by injectable CGRP treatments from Amgen, Eli Lilly and Teva.
After their own survey of 99 primary care doctors last fall, Piper Sandler analysts projected more success for Biohaven’s drug at the expense of Ubrelvy. Based on the survey results, Piper Sandler estimated 2023 sales of $1.38 billion for Nurtec versus $769 million for Ubrelvy and $437 million for Amgen’s injectable Aimovig.
The analysts were highly optimistic over Qulipta’s opportunity for quick uptake, pegging 2023 sales at $735 million, nearly twice the Wall Street consensus of $370 million.