Aduhelm (Aducanumab) Value vs. Its Truly Restricted Market, and The Same for Blarcamesine $BIIB $AVXL

Do not trade this blog as 4 billion years of evolution is against me and possibly even God laughs at it, He has a great sense of humor! And I am long $AVXL $ANVS $CRTX FYI

Biogen surge of $15bln in market capitalization due to Aduhelm approval does match the restricted market the drug faces. I am taking off where Lane Simonian left without giving any numbers in its latest SeekingAlpha article, link: https://seekingalpha.com/article/4435705-post-biogen-post-amyloid-world-for-alzheimers-disease .

Following Bazilian study looked at the incidence of all allels of the APOE gene in Late-Onset Alzheimer’s Disease (LOAD). Link: https://pubmed.ncbi.nlm.nih.gov/22068907/. This is the table with the distribution of APOE e4 gene in the LOAD population.

The control group lists something like the number of APOE e4e4 people in the general population. It is indeed a miniscule number, but due to its high odds to develop Alzheimer’s the poplution of LOAD sufferes with both e4 alleles is at 13% of all cases. You can expect that discrepancy in the light of odds almoet 14 times larger to develop LOAD than general population.

Annually, about 500,000 new cases of Alzheimer’s are diagnosed. I would add that Aduhelm should not be prescribed to those who a advanced into the disease more than that. This gives 56,000 patients to be dosed at $56,000 a year. Is this any numerlogical coincidence? The revenue from the drug might reach ~$3.16bln. Looking at cool 1/3 going towards the bottom line ~$1.05bln, with 20 P/E ration gives $21bln market capitalization. Indeed prized like an orphane disease.

If the inital success of Blarcamesine in Phase 2a High Concentration Cohort will be replicated and even improved in Phase 2b/3, what can we expect? Let’s make some assumptions; average length of dosing 5 years but we only will consider 1 year, 50% of those diagnosed (50% of 500,000=250,000) on the drug as the drug works on 80% population at the least, annual cost $20,000 (a off the patent generic CNS medication cost about that $8,000/y ) and half the revenue goes to bottom line. $AVXL Market capitalization could reach ~$50bln initially.

This analysis does not involve the idea of all the 50’s old people taking small doese to gaurd against senescence. I have pointed out that there are the three Alzheimer’s epidmics. Those with healthy bodies getting early disease and after 5-10 years dying of Alzheimer’s, those slowly deteriorating due to senescence and those who start deterirating rapidly from low cognition level already (due to age) and dying due to other comorbidity. The incoming evidence in basic research points that SIGMAR1 receptors agonist could tackle the three populations of dementia patients making dementia a rare occurance in later life. You can look at the previous posts on this blog which document the outpouring of possible etiologies of Alzheimer’s, all connected to the SIGMAR1 receptor mecanism of action. If the numbers of patients taking Blarcamesine can be extended to general population the calcuation of the $AVXL bottom line become too spectatula and speculative to ponder even if Congress will put restrictions on drug price .

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