In the fiercely competitive market for new Alzheimer's drugs, Biogen (BIIB.US) CEO Christopher Viehbacher recently stated that the at-home injectable version of Leqembi, co-developed with Eisai, will be a "critical advantage" for the company against competitor Eli Lilly's (LLY.US) similar therapy. Although Lilly's Kisunla entered the market over a year later than Leqembi, it has rapidly captured market share, and the two companies are now nearly neck-and-neck in terms of new patient market share.
To solidify its leading position, Biogen and Eisai jointly developed a more convenient subcutaneous injection formulation for patient self-administration at home. Last year, U.S. regulators approved patients to continue using this formulation themselves after completing the initial 18 months of infusion therapy at a medical facility.
A larger market opportunity may arrive by mid-year—the two companies anticipate receiving U.S. approval to allow patients to use Leqembi at home from the very start of treatment. Viehbacher, speaking at the J.P. Morgan Healthcare Conference in San Francisco, said this "is likely to become the most important growth driver in the future."
In contrast, Lilly's drug does not currently offer an at-home administration option. "We believe that, compared to infusion, the subcutaneous injection will be more favored by patients," Viehbacher said regarding the home-use injectable.
Biogen's investors are closely watching the market rollout of Leqembi. Approved in early 2023, its growth momentum has been relatively modest, partly due to bottlenecks in the healthcare system, including Alzheimer's patients competing with cancer patients for infusion chair availability.
Allowing patients to use Leqembi at home could improve convenience and accelerate its adoption. Similarly, new blood test technologies that can speed up the diagnosis of new patients could also fuel growth.
In the long term, both Biogen and Eli Lilly hope to demonstrate the benefits of early treatment through clinical trials, potentially even before people begin showing symptoms of the mind-robbing disease. This would significantly expand the market size. Biogen expects to announce the results of this trial in 2028.
"If you start treatment early, can you preserve more cognitive ability?" Viehbacher said. "This is almost certainly the future direction of Alzheimer's treatment."
Since taking over as CEO more than three years ago, Viehbacher has cut hundreds of jobs and reduced expenses. He has also struck a series of deals to diversify the company's R&D and commercial pipeline.
The largest of these was Biogen's $7.3 billion acquisition of Reata Pharmaceuticals in 2023, which brought Skyclarys—the first drug approved to treat the rare neurological disease Friedreich's ataxia. Last year, Biogen entered into multiple early-stage research collaborations in the immunology field, an area known for producing blockbuster products like AbbVie's arthritis drug Humira.
Viehbacher stated that Biogen may pursue more acquisitions, although he believes a deal's value is unlikely to exceed $5 billion. "If we can find another near-term growth asset that fits our product line layout and is financially reasonable, we would likely do it," he said. "This is not something we feel we must do, but we are continuously looking for opportunities."
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