Eisai Adjusts Leqembi Sales Projections Amid Slow US Uptake, Looks to Streamline Treatment

Eisai, the Japanese pharmaceutical giant, has revised its sales forecasts for Leqembi, its groundbreaking Alzheimer's disease therapy, citing slower-than-expected uptake in the US market. The company is now focusing on strategies to boost adoption and streamline the treatment process, while also developing new formulations to enhance patient accessibility.

Revised Sales Projections and Market Challenges

Eisai's latest corporate presentation revealed a significant adjustment to its fiscal year 2027 sales projections for Leqembi. The company now anticipates sales between ¥250 billion to ¥280 billion (approximately $1.7 billion to $1.9 billion) for the fiscal year ending March 2028. This forecast represents a substantial 50% reduction from the previous year's projection of ¥500 billion (around $3.3 billion).

Despite being the first fully approved anti-amyloid antibody treatment for Alzheimer's disease, Leqembi has faced challenges in market adoption. In November 2024, Eisai had already lowered its fiscal year 2024 sales expectations to $280 million, down from an initial $370 million forecast. However, recent reports indicate that the company is on track to meet this adjusted target, with US sales showing signs of improvement.

Strategies for Growth and Treatment Optimization

To address the slower-than-expected uptake, Eisai is implementing several strategies aimed at enhancing Leqembi's market presence and simplifying the treatment process:

1. Direct-to-patient engagement: The company plans to increase brand awareness through targeted communication, supporting informed medical decision-making.

2. Streamlined referral process: Eisai is developing a collaborative system among integrated delivery networks and primary care physicians to reduce patient referral time.

3. New formulations: The company is working on a subcutaneous formulation of Leqembi for maintenance dosing, with an FDA decision expected by August 31, 2025. This alternative to IV infusion could significantly improve treatment accessibility and reduce the burden on healthcare facilities.

4. Autoinjector development: Eisai is exploring the potential for a subcutaneous autoinjector, which could allow for self-administration and further simplify the treatment process.

Current Market Status and Future Outlook

As of the latest report, approximately 13,500 patients are currently receiving Leqembi treatment, with 3,000 physicians prescribing the drug. While US adoption has been slower than anticipated, overseas revenues are driving growth.

Eisai remains committed to Leqembi's long-term potential, viewing fiscal year 2027 as a significant milestone in the drug's trajectory. The company has initiated a three-year rolling plan to assess progress and adjust strategies as needed.

Despite the current challenges, Eisai's chairman and CEO, Tatsuyuki Yasuno, maintains an optimistic outlook, stating that "the Leqembi business is continuously growing stronger." The company continues to focus on neurology and oncology R&D investments, partnership opportunities, and in-house manufacturing capabilities to support its medium to long-term growth strategy.