Biogen's Tecfidera snaps up managed care coverage en route to blockbuster sales

Biogen Idec's ($BIIB) multiple sclerosis pill Tecfidera has had no problem taking the market by storm since its launch in April. And armed with new reimbursement data, analysts now say more revenue growth is on the way: An already-broad reimbursement base should help Tecfidera, a drug expected to hit peak sales of $3.78 billion, as it competes with rival pills from Novartis ($NVS) and Sanofi ($SNY).

According to Leerink Swann analyst Marko Kozul, a survey of 39 pharmacy directors who make decisions for managed care organizations showed that insurers had begun coverage of Tecfidera unusually soon after its launch. "While insurers often wait ~6 months from the time of a new drug launch to implement meaningful reimbursement, this first survey suggests robust coverage has already been established," he wrote in a note. That includes approximately 75% of the 22 million whose pharmacy directors took the survey--meaning they would have been covered for Tecfidera, had they needed it, in its first 7 months.

As Kozul points out in the note to investors, that number bodes well for revenue going forward: He expects $220 million in sales for Q3 and said Leerink's Q4 estimate of $314 million in sales for the drug may be conservative. That would follow a stellar launch that led to first-half sales of $192.1 million.

And what's more, Kozul expects Biogen Idec's decision to provide the drug for free for up to one year to those with insurance who have been denied reimbursement will keep them from switching to a competitor's therapy. Sanofi's Aubagio and Novartis' Gilenya--oral therapies that preceded Tecfidera on the market--both represent threats, though so far, Tecfidera has kept them at bay. According to RBC Capital Markets analyst Michael Yee, Tecfidera is besting the pair with a 13% share of the market, compared with their combined 12.3%.

With steady total prescription growth at 20% for the quarter to date, Yee thinks Biogen's pill could increase its piece of the pie to 15% by the end of this year. But one major challenge still remains for Tecfidera going forward, and that's a European launch. While some estimate European sales could eventually make up 40% of Tecfidera revenues, Biogen has so far held off because of intellectual property concerns.

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