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2013 Should Be Interesting for Multiple Sclerosis Drugs

Brian Orelli
December 31, 2012

Times are a-changing. This has been a big year for multiple sclerosis drugs. And 2013 looks like it'll be the start of a major inflection point in the space.

Dominant players
The market is currently ruled by Teva Pharmaceuticals' (NYSE: TEVA) Copaxone, Rebif -- marketed by Pfizer (NYSE: PFE) and Merck KgaA -- Biogen Idec's (NASDAQ: BIIB) Avonex, Bayer's Betaseron, and Novartis' (NYSE: NVS) Extavia, which is the exact same drug as Betaseron sold under a different label (the back story, if you're interested, can be found here).

They all have to be injected, which is a turnoff to newly diagnosed multiple sclerosis patients. But they've been around awhile, and doctors have a lot of experience with their ability to slow down the progression of the disease.

Biogen and Elan (NYSE: ELN) sell Tysabri, which has to be infused at a doctor's office. Despite efficacy that looks better than the injectable drugs, a potentially lethal side effect pushed the drug to use as a second-line therapy. This year, the companies developed an assay to identify patients more likely to develop the brain infection called progressive multifocal leukoencephalopathy, which seems to have invigorated sales for patients who test negative.

2013: The year of the oral MS drug?
2010 certainly wasn't. That's the year Novartis' Gilenya was approved. As I predicted at the time, it took a while for sales of the drug to take off. But they finally have. Sales through the first nine months