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Under-the-gun Acorda slashes Inbrija sales forecast amid lackluster launch

Acorda Therapeutics suffered a major blow in late 2018 when it lost four patents on multiple sclerosis med Ampyra. The drug cratered in the face of generic competitors, Acorda slashed jobs and costs, and then shifted focus to its $800 million Parkinson’s hopeful Inbrija.

But that hasn’t worked out so far, and an underwhelming launch now has Acorda aiming way lower on the drug’s chances.

More than a year into its launch, Inbrija raked in just $15.3 million in sales in 2019, a far cry from the lofty $800 million goal Acorda outlined in its annual report a year ago. 

In an earnings call with analysts Thursday, CEO Ron Cohen blamed Inbrija’s lackluster performance on first-year reimbursement issues that left physicians “preconditioned” to avoid prescribing the inhalable drug. 

“We really thought going into the market at launch, even though we knew there would be reimbursement challenges, we thought uptake would be significantly higher than it was,” Cohen said. “There is this odd disconnect where the physicians by and large are quite enthusiastic, but you don’t see that in the first year of prescribing information.”

Acorda downgraded its peak sales estimate for Inbrija to between $350 million and $500 million, revising a more than $500 million estimate that Cohen said was “not as informed as (it is) now.” Despite the slow uptake, Acorda forecast 2020 sales of Inbrija between $35 million and $40 million.

In Cohen’s telling, Inbrija is ready for a sales turnaround after the drugmaker has fought tooth and nail for market access. With physician and patient enthusiasm high, Cohen predicted that increased sales could soon follow, now that doctors have fewer hurdles to face with reimbursement. 

“We found that doctors have been preconditioned by other product launches that when they start writing, the more of a time sink it is because insurers keep throwing back prescriptions,” Cohen told analysts. “That’s where we really underestimated the impact when we went in, and that’s where we are now.”

But even if Inbrija does nail its heel turn, Acorda will be left coping with nosediving sales of Ampyra, which hit just $163 million in 2019 after a $455 million year in 2018. 

In September 2018, the U.S. Court of Appeals for the Federal Circuit upheld a lower court’s ruling that four Ampyra patents were invalid, putting the drug up for generic competition almost immediately. Despite sales dropping by nearly 75% on the year, Cohen painted a relatively rosy picture Thursday, arguing that the drugmaker had maintained a “robust tail” for Ampyra through a well-executed loss of exclusivity plan and lasting “brand loyalty.”

This year, Acorda predicts Ampyra will continue its decline to between $85 million and $110 million in sales.