Amgen's Aimovig, under fire from Lilly, loses grip on next-gen migraine share

Amgen had a head start with its first-to-market CGRP launch Aimovig, but its rivals are giving the company some fierce competition.  

As of the week ended Aug. 23, Aimovig now holds less than half of the total CGRP market, a first for the drug. In recent weeks, it had been hovering at or above 50%.  

Eli Lilly’s third-to-market Emgality, which held 31% of the market as of the week ended Aug. 23, is the only med in the class that's been growing market share over the last eight weeks, SVB Leerink analysts wrote in a note detailing IQVIA prescription data.

Meanwhile, Teva’s Ajovy is holding third place in the market share race with 20% of total prescriptions. Over the last two months, Lilly has grown its market share 3%, while Teva has lost 2% and Amgen lost 1%, according to IQVIA data.  

CGRP migraine prevention drugs won approvals starting in May last year and are each important to their companies for similar reasons. Each company is dealing with patent expirations, so the closely watched CGRP launches are helping offset declines elsewhere. Teva in particular doesn’t have many growth drivers, so Ajovy is playing an outsized role in the company’s outlook.

In the sales race, Amgen holds the lead. Aimovig bested its competition in second-quarter sales with $83 million, followed by $34 million for Emgality and $23 million for Ajovy. Each company started its launch by offering free drugs while payer negotiations played out, so they’re now working to move patients over to paid scripts.  

On Lilly’s second-quarter conference call, Chief Financial Officer Josh Smiley said the company captured 41% of the share of new prescriptions at the end of the quarter, up 9% from its position at the end of the first quarter. He said the company has "best-in-class access" and anticipates Emgality "contributing meaningfully to sales in the second half of 2019." 

It's still early in the race, though, Amgen’s Murdo Gordon, executive vice president of global commercial operations, said on his company’s second-quarter conference call. So far, market penetration is low, as there are 4 million eligible patients in the U.S., he said. Seven thousand patients are starting CGRP drugs per week, he noted, and 27,000 doctors have prescribed Aimovig so far.

On Teva’s second-quarter call, CEO Kåre Schultz said his company is "satisfied" with Ajovy’s total prescription market share. Teva expects a little under $150 million in sales from the drug this year, he added. Looking ahead, the company anticipates the approval of an Ajovy autoinjector to bolster the launch. 

While each drug is approved to prevent migraines, Lilly’s Emgality also recently won an FDA nod to treat patients with cluster headache, becoming the first drug approved in the indication in decades. 

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