Alnylam Pharmaceuticals: 2Q preview: Looking for potential updated TTR revenue guidance

Research evidence excerpt

Alnylam Pharmaceuticals: 2Q preview: Looking for potential updated TTR revenue guidance

Model changes

In our DCF, we roll the quarter and lower our long-term ATTR-CM revenue estimates as

we expect further impact from price erosion in the long-term. Amvuttra in ATTR-PN now

contributes $36/share (prev. $41), Amvuttra in ATTR-CM now contributes $201/share

(prev. $227), nucresiran in ATTR-PN now contributes $14/sh (prev. $17) and nucresiran

in ATTR-CM now contributes $69/sh (prev. $86). These changes result in our new $410

PO (prev. $460).

ATTR-CM Treatment Survey

We conducted a survey (June 15th -June 30th) with 25 cardiologists to gain insights into

the evolving transthyretin amyloidosis cardiomyopathy (ATTR-CM) landscape and

dynamics of the Amvuttra (vutrisiran) launch. After a strong initial uptake for Amvuttra in

ATTR-CM, we looked to gain further insights into prescribing trends in 2Q and long-term

expectations for use as the launch continues to mature.

We surveyed 25 cardiologists treating 3,126 ATTR-CM patients

Our survey included 25 cardiologists treating 3,126 ATTR-CM patients. Our respondents

indicated that on average 72% of their patients are wild-type and 28% have hereditary

ATTR-CM. 21 out of 25 (84%) respondents indicated they work at a center of excellence.

We think the survey is representative of a broad range of cardiologists but note that it is

still a limited sample size.

Most patients are covered by Commercial or Medicare Advantage plans

Our respondents indicated that on average 37% of their patients are on commercial

insurance, 27% are on Medicare Advantage plans, 23% are on Medicare Fee for Service

(FFS) and 13% are on Medicaid/Government plans (Exhibit 1). This distribution is in-line

with our previous surveys.