How can Teva's migraine drug face off Amgen and Lilly? Put neurologists first, DTC last, executive says

Ajovy
Teva's Ajovy scored FDA approval in September, trailing Amgen and Novartis' Aimovig. (Teva)

Teva faces some tough rivals in the next-generation migraine market, and Amgen and Eli Lilly each have bragging rights for their drugs—first by sales and first by new scripts, respectively. But the Israel-based drugmaker thinks its own Ajovy can win, too. And it has an underdog-style marketing plan to get there.

Though Lilly is already shelling out big bucks on TV advertising for its entrant, Emgality, Teva's not planning to put up its own warring campaign. Instead, it's relying on multichannel advertising to get the word out, Teva EVP Brendan O’Grady told FiercePharma via email.

And rather than deploy a huge sales force across the primary care spectrum, Teva's looking to target a smaller group with its “right sized sales force,” said O’Grady, who heads up Teva's North America commercial operations.

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Ajovy reps will be focusing on neurologists and high-prescribing doctors outside of that specialty field. “We've got a competitive share of voice and we think that we're currently effectively resourced to compete, and we'll continue to do so,” O’Grady said. 

As the CGRP migraine drug field takes shape, Teva has snagged 23% of the market, O'Grady said. That figure puts Ajovy in third place, share-wise, behind Amgen's Aimovig and Lilly's Emgality, according to comments from executives during each of those companies' recent conference calls.

On Teva's first-quarter conference call with analysts, Teva executives said they believe Ajovy can pull in $150 million this year and grow substantially as time goes by. But the drug is competing against Amgen’s first-to-market advantage with Aimovig and Eli Lilly’s noted marketing muscle for Emgality.

RELATED: Teva’s sunny forecast for crucial migraine drug Ajovy raises eyebrows on Wall Street 

Lilly spent $15.1 million on Emgality TV ads in April, bringing its total since the campaign launched in February to $43.5 million, according to real-time ad tracker iSpot.TV, putting the brand among the most-advertised on television. And it appears to be working: On Lilly’s first-quarter call, Lilly Bio-Medicines President Christi Shaw said Emgality had passed up Ajovy in new prescriptions and total prescriptions after reaching the market third. And Lilly expects Emgality to beat Aimovig in new prescriptions this quarter, she added. 

TV isn't the be-all and end-all of a drug launch, though, and Teva's behind-the-scenes negotiations could make a big difference—if they're successful. So far, formulary decisions and reimbursement are the “driving factor behind many CGRP prescribing decisions,” RBC Capital Markets analyst Randall Stanicky wrote in a note last month after surveying 30 neurologists and hosting doctors at a New York City event. 

And while Ajovy's delivery mode—a prefilled syringe—puts it at "a modest disadvantage" to its rivals, the drug also offers the only quarterly dosing option in the class, Stanicky wrote. Teva plans to launch an Ajovy autoinjector by the end of the year, O'Grady said.

But Teva arguably has more on the line with its Ajovy launch than its rivals do. The CGRP market is one of the company’s “few important growth drivers," Stanicky pointed out. And amid a costly generic slide for multiple sclerosis drug Copaxone and a $3 billion cost-cutting campaign, Ajovy is one of only a couple of new drugs the company can rely on to boost revenue down the line.

RELATED: Lilly asks migraine patients to use their imaginations in first DTC push for Emgality

Ajovy generated $20 million in the first quarter, while Lilly's Emgality pulled in $14.2 million. Amgen's Aimovig bested both of them with $59 million in first-quarter sales. All three companies are using free drugs to help patients get onto therapy and plan to continue transitioning patients to paid scripts.

Teva and Eli Lilly may benefit from the dispute between Amgen and Novartis on their Aimovig partnership. The companies recently sued each other as Amgen tries to cancel the deal by arguing that Novartis violated the contract. Novartis, for its part, wants to save the collaboration. As the lawsuits play out, the companies contend their Aimovig marketing won’t be affected.

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