Bristol Myers Squibb believes Alzheimer's is the largest marketplace for its newly approved schizophrenia drug, Cobenfywhich is predicted to ultimately generate billions of dollars in revenue.
In an interview, company executives said each treatment use they’re exploring for Cobenfy has multibillion-dollar potential, including Alzheimer's psychosis, Alzheimer's agitation and cognition, bipolar disease and autism. But Alzheimer's is the “really big market” here, Bristol Myers Squibb CFO David Elkins told CNBC on Tuesday on the JPMorgan Health Care Conference in San Francisco.
There are nearly 6 million patients with Alzheimer's disease within the U.S., and about half of them suffer from psychosis or symptoms comparable to hallucinations and delusions, Elkins said. Cobenfy might be the primary drug approved specifically for Alzheimer's-related psychosis, Chief Commercialization said Officer Adam Lenkowsky.
Atypical antipsychotics – drugs used to treat various psychiatric disorders – are sometimes used to treat psychosis in Alzheimer's patients, although they aren’t approved for this purpose. However, based on Bristol Myers Squibb, these treatments can increase the chance of death, which shouldn’t be the case with Cobenfy.
It is now estimated that roughly 60 to 70% of patients are affected by Alzheimer's agitation, a symptom that may cause a patient to feel restless and anxious some studies.
Bristol Myers Squibb said Monday that it plans to publish initial trial data on Cobenfy within the treatment of Alzheimer's-related psychosis within the second half of the 12 months, sooner than expected. The company also expects to start Phase 3 trials in Alzheimer's agitation, Alzheimer's cognition and bipolar disorder in 2025, while trials in autism will begin in 2026.
JPMorgan analyst Chris Schott expects Cobenfy sales to succeed in about $5 billion by 2030, with peak sales potential within the $10 billion range for various treatment applications, based on a research note Tuesday. That's an enormous boon for Bristol Myers Squibb as the corporate faces pressure to offset potential lost sales of top-selling treatments whose patents are expiring.
This brings Cobenfy full circle, which, when approved in September, became the primary novel treatment for the roughly 3 million U.S. adults with schizophrenia in many years. The drug comes from Bristol Myers Squibb's whopping $14 billion acquisition of biotech company Karuna Therapeutics in late 2023.
However, the drug's roots lie within the treatment of Alzheimer's disease.
Eli Lilly originally tested a part of the drug – xanomeline – within the Nineties to scale back cognitive decline before shelving it resulting from serious unintended effects including nausea, vomiting, diarrhea and constipation. Xanomeline prompts certain so-called muscarinic receptors within the brain to scale back dopamine activity without causing the unintended effects related to antipsychotics.
Andrew Miller, founder and former president of research and development at Karuna Therapeutics and now an advisor to Bristol Myers Squibb, recognized xanomeline's potential in neuroscience and theorized that combining xanomeline with a second existing drug – trospium – would scale back these unintended effects. He then founded Karuna to develop the mixture to treat schizophrenia.
Other groundbreaking treatments for Alzheimer's have recently come to market, including: Biogenic And Eisai's Lekmbi and Eli LillyThis is Kisunla. These treatments work partly by eliminating toxic plaques within the brain called amyloid, an indicator of Alzheimer's, to slow the decline in memory and pondering skills in patients with early Alzheimer's disease
But because the disease progresses, people experience symptoms comparable to psychosis and agitation, said Elkins of Bristol Myers Squibb.
“Cobenfy fits here,” he said. “If you may do away with the psychosis and the restlessness, people's perception improves. Imagine how impactful this drug might be for caregivers and the healthcare system as a complete for these patients and their families. It's really exciting when you concentrate on it on this context.
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