10. Mayzent

Novartis headquarters
Up to 80% of patients with relapsing remitting multiple sclerosis go on to develop secondary progressive MS, and they’ll be in line for the Novartis drug, which bears an $88,500-per-year sticker. (Wikimedia Commons/Andrew/Flickr)

Generic name: siponimod
Company: Novartis
Disease: secondary progressive multiple sclerosis
2024 sales estimate: $1.30 billion 

The multiple sclerosis market is a crowded one, but Novartis’ Mayzent broke onto the scene with something no other oral player has: an approval in the secondary progressive form of the disease.

Mayzent’s green light made it the first new therapy approved specifically for SPMS in more than 15 years, giving the drug a chance to rack up major sales in a sizable market. Up to 80% of patients with relapsing remitting MS go on to develop SPMS, and they’ll be in line for the Novartis drug, which bears an $88,500-per-year sticker.

RELATED: Can Novartis MS blockbuster-to-be break Mayzent break doctors’ ‘circle of denial’?

The problem? Patients don’t always know they’ve moved into SPMS territory—and their doctors don’t, either.

“In most cases, this is a retrospective diagnosis,” Danny Bar-Zohar, Novartis’ global head of neuroscience development, said in an interview ahead of Mayzent’s March approval. “The patients and the physicians look backward and they tell each other, ‘Ah, yeah, maybe two years ago you actually started the SPMS because retrospectively, we see your trajectory.'”

Novartis’ challenge? First off, getting doctors to diagnose SPMS, which the company is doing in part by promoting a short list of questions about MS symptoms. It’s also working on upping awareness among physicians who treat the condition.

RELATED: Novartis could snag a blockbuster MS market all for itself, just in time to fight Gilenya generics

Novartis isn’t new to the field, though, and it intends to put its experience to good use. The company already has relationships within the MS community, thanks to fellow oral MS therapy Gilenya. Building awareness about Mayzent is “really leveraging what we’ve had there and extending it to this community,” company spokesman Eric Althoff said in March.

10. Mayzent