Doctors are coming around to Teva's Austedo as TD drugs get more play: analyst

In the brand-new tardive dyskinesia market, doctors initially preferred Neurocrine’s Ingrezza over Teva’s Austedo. But that edge is weakening, one analyst says.

These days, doctors are viewing the two drugs as “more similar than different,” Leerink Partners analyst Ami Fadia wrote in a Monday note to clients. According to a survey conducted by the firm, physicians see the Teva drug snapping up 45% of peak market share, compared with Ingrezza’s 55%; that’s an improvement from the 65-35 split they predicted in September.

“Physicians are starting to put Austedo on a more even competitive level with Ingrezza in TD,” he wrote.

That’s one reason Fadia and his colleagues are now predicting Austedo will snap up an additional $100 million in 2019 and $200 million in 2023, a bump that brings 2023 sales to blockbuster territory at more than $1 billion.

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It’s not just Austedo that’s benefiting as doctors get familiar with the VMAT2 class of therapies, though.

“Overall, the trends are positive for both” products, Fadia wrote, with doctors viewing 66% of TD patients as candidates for treatment. In September, that number sat at just 53%, and in January 2017, doctors tabbed just 42% of patients as eligible.

“We do believe that physician experience is improving the appetite to prescribe VMAT2s, and this could continue to get incrementally better over time,” Fadia said.

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Meanwhile, as Teva works to implement 14,000 layoffs and $3 billion in cost cuts, Austedo and the marketing push behind it are being spared. “We have of course made sure we have the resources” to support a “successful launch of Austedo,” CEO Kåre Schultz said in December.

The drug is also indicated for chorea associated with Huntington’s disease, but the way Fadia sees it, that’s a “small” sales opportunity for the therapy. It only boasts a “slightly favorable profile” to generic tetrabenazine, and “reimbursement remains a key reason” doctors aren’t using it, he said.