Amgen Patient Finder Suitability Analysis
Prepared for: Ada Health CEO - Daniel Nathrath
Date: March 11, 2026
Report Type: Investor-Grade Patient Finder Opportunity Assessment
Executive Summary
This analysis evaluates Amgen's drug portfolio for Ada Patient Finder suitability using the v4 framework. Ada finds undiagnosed patients via symptom assessment and navigates them to care.
Revenue model: 8-12% of first-year drug revenue per patient found
Total Combined Opportunity: $895M - $2.16B annually across Tier 1-3 drugs at 5% penetration
Top Opportunities - Executive Summary Table
| Tier |
Drug |
Indication |
Fit Score |
Addressable Undiagnosed (USA) |
Ada Revenue Opportunity (5% penetration) |
| 1 |
UPLIZNA |
Generalized myasthenia gravis (gMG) |
8/10 |
10-15K |
$141-431M |
| 1 |
TEPEZZA |
Thyroid eye disease (TED) |
8/10 |
10-15K |
$201-638M |
| 2 |
KRYSTEXXA |
Refractory chronic gout |
7/10 |
75-125K |
$598M-1.98B |
| 3 |
Repatha |
Familial hypercholesterolemia (FH) |
6/10 |
50-100K |
$8.1-31.5M* |
| 3 |
TEZSPIRE |
Severe uncontrolled asthma |
6/10 |
300-500K |
$536M-2.12B* |
*Repatha and TEZSPIRE require alternative pricing model (flat fee per patient vs. percentage-based) due to low net revenue per patient.
TIER 1: STRONG FIT (Scores 8-10)
1. UPLIZNA (inebilizumab-cdon) - Generalized Myasthenia Gravis (gMG)
Fit Score: 8/10 |
Ada Surface Ability: 9/10 |
Company Motivation: 9/10
Approved Indications
- Generalized myasthenia gravis (gMG) in anti-AChR or anti-MuSK antibody-positive adults (FDA approved December 2025)
- IgG4-related disease (IgG4-RD) in adults (FDA approved April 2025)
- Neuromyelitis optica spectrum disorder (NMOSD) in AQP4-IgG seropositive adults
Market Numbers (USA)
| Total MG Prevalence |
116,255 (35.7 per 100,000) |
| Generalized MG (gMG) |
~98,800 (85% of total MG) |
| Undiagnosed/Delayed Diagnosis |
~20-30K (20-30% with 1-2 year delays) |
| Drug-Addressable Undiagnosed |
~10-15K (refractory gMG subset) |
| Net Revenue per Patient |
~$200-220K/year |
| Annual Revenue (FY2025) |
$655M (+73% YoY) |
| Peak Revenue Estimate |
$1.5B+ with gMG, IgG4-RD, CIDP, AIH indications |
Clinical & Diagnostic Profile
Key Symptoms: Ptosis (drooping eyelids), diplopia (double vision), fluctuating muscle weakness that worsens with activity and improves with rest
Diagnostic Delay: 1-2 years median; 48% initially misdiagnosed
Ada's Detection Capability: HIGH - Classic triad of ptosis + diplopia + fluctuating weakness is highly specific to MG
Economic Opportunity
| Market |
Addressable Undiagnosed |
Ada Revenue (1% penetration) |
Ada Revenue (5% penetration) |
| USA |
10-15K |
$16-40M |
$80-198M |
| DACH |
3-4.5K |
$4-11M |
$21-53M |
| ROW |
10-20K |
$8-36M |
$40-180M |
| TOTAL |
23-40K |
$28-87M |
$141-431M |
Pitch Hook: "Generalized myasthenia gravis affects 100,000+ Americans, but diagnostic delays average 1-2 years as patients are misdiagnosed with thyroid disease, stroke, or depression. MG's hallmark symptoms—ptosis (drooping eyelids), double vision, and muscle weakness that worsens with activity—create a unique diagnostic signature Ada can surface with high specificity. UPLIZNA, approved for gMG in December 2025 and generating 73% year-over-year growth ($655M in FY2025), treats refractory gMG with net revenue exceeding $200,000 per patient annually. Ada can drive case-finding for UPLIZNA by identifying undiagnosed MG patients via this classic symptom triad, prompting neurology referral and accelerating time-to-treatment in a high-value rare disease market."
2. TEPEZZA (teprotumumab-trbw) - Thyroid Eye Disease (TED)
Fit Score: 8/10 |
Ada Surface Ability: 8/10 |
Company Motivation: 10/10
Market Numbers (USA)
| Moderate-to-Severe TED Requiring Treatment |
50K-100K prevalent cases |
| New TED Cases Per Year |
15-20K |
| Underdiagnosed/Delayed Referral |
20-30K (30-40% not promptly referred for TEPEZZA) |
| Drug-Addressable Undiagnosed |
10-15K annually |
| Net Revenue per Patient |
~$300-350K per course |
| TEPEZZA Global Market (2024) |
$1.9B ($381M Q1 2025) |
| Peak Revenue Estimate |
$2B+ with subcutaneous formulation |
Clinical & Diagnostic Profile
Key Symptoms: Eye bulging (proptosis), double vision (diplopia), eye pain and pressure, eye redness/swelling
Diagnostic Delay: Referral delays from endocrinology to ophthalmology (no specific data on diagnostic delay duration)
Ada's Detection Capability: MODERATE-HIGH - Eye bulging + double vision + eye pain in Graves' patients is highly specific
Competitive Position: First-and-only FDA-approved treatment (monopoly), pipeline competitors 2-3 years away
Economic Opportunity
| Market |
Addressable Undiagnosed |
Ada Revenue (1% penetration) |
Ada Revenue (5% penetration) |
| USA |
10-15K |
$24-63M |
$120-315M |
| DACH |
3-5K |
$6.5-19.5M |
$32.5-97.5M |
| ROW |
8-15K |
$9.6-45M |
$48-225M |
| TOTAL |
21-35K |
$40-128M |
$201-638M |
Pitch Hook: "Thyroid eye disease affects 25-50% of Graves' disease patients, causing debilitating eye bulging, double vision, and pain. TEPEZZA is the first and only FDA-approved medical treatment, yet many TED patients experience referral delays from endocrinology to ophthalmology, postponing access to this breakthrough therapy. Ada can identify undertreated TED patients by surfacing eye bulging, double vision, and eye pain in users with known Graves' disease or hyperthyroidism, prompting ophthalmology referral and accelerating TEPEZZA access. With net revenue exceeding $300,000 per patient and Amgen's monopoly positioning (first-and-only treatment, orphan exclusivity through 2030+), Ada can drive significant volume expansion. At 5% penetration across USA, DACH, and ROW, TEPEZZA represents a $201-638M annual opportunity for Ada—the highest per-patient revenue in Amgen's portfolio, with zero direct competition."
TIER 2: GOOD FIT (Score 7)
3. KRYSTEXXA (pegloticase) - Refractory Chronic Gout
Fit Score: 7/10 |
Ada Surface Ability: 6/10 |
Company Motivation: 9/10
Market Numbers (USA)
| Total Gout Prevalence |
>10 million (~4% of population) |
| Chronic Refractory Gout (CRG) |
~200-250K in USA (>400K in 7MM) |
| Underrecognized as Refractory |
~150-250K (50% not recognized or referred) |
| Drug-Addressable Undiagnosed |
~75-125K |
| Net Revenue per Patient |
~$100-120K per course |
| Annual Revenue |
$800M+ run rate (2023 baseline) |
| Peak Revenue Estimate |
$1.5B+ with methotrexate combination adoption |
Clinical & Diagnostic Profile
Key Symptoms: Frequent gout flares (≥3/year), visible tophi (lumps on joints/ears), chronic joint pain despite maximum conventional therapy
Diagnostic Challenge: Refractory status underrecognized - patients left on inadequate xanthine oxidase inhibitor therapy
Ada's Detection Capability: MODERATE - Can surface frequent flares + tophi, but requires patient to report existing gout diagnosis
Competitive Position: First-and-only infused biologic for refractory gout (monopoly)
Economic Opportunity
| Market |
Addressable Undiagnosed |
Ada Revenue (1% penetration) |
Ada Revenue (5% penetration) |
| USA |
75-125K |
$60-180M |
$300-900M |
| DACH |
30-50K |
$47-144M |
$234-720M |
| ROW |
20-40K |
$13-72M |
$64-360M |
| TOTAL |
125-215K |
$120-396M |
$598M-1.98B |
Pitch Hook: "300,000-500,000 Americans suffer from refractory chronic gout, enduring frequent flares and disfiguring tophi despite maximum conventional therapy, yet many remain underrecognized and untreated with KRYSTEXXA—the only FDA-approved infused biologic for this population. Ada can identify refractory gout patients by surfacing frequent flare patterns (≥3 flares per year), visible tophi ('lumps on joints or ears'), and inadequate uric acid control on allopurinol, prompting rheumatology referral. With KRYSTEXXA generating $800M+ annually, net revenue of $100-120K per patient, and Amgen's first-mover monopoly position, Ada can drive volume expansion in a high-revenue-per-patient market with significant unmet need. At 5% penetration across USA, DACH, and ROW, KRYSTEXXA represents a $598M-1.98B annual opportunity for Ada—one of the largest opportunities in Amgen's rare disease portfolio."
TIER 3: MARGINAL FIT (Score 6)
4. Repatha (evolocumab) - Familial Hypercholesterolemia
Fit Score: 6/10 |
Ada Surface Ability: 7/10 |
Company Motivation: 8/10
Key Challenge
Massive underdiagnosis (>98% of 1.3M Americans with FH undiagnosed) but low net revenue per patient ($2,500-3,000/year) makes percentage-based model uneconomical. Alternative pricing model recommended: $500-1,000 flat fee per patient identified.
| FH Prevalence (USA) |
1.3 million (1 in 250 adults) |
| Undiagnosed FH |
~1.28-1.48M (>90%) |
| Drug-Addressable Undiagnosed |
50-100K annually |
| Annual Revenue (FY2025) |
$3.5B+ (+36% YoY) |
5. TEZSPIRE (tezepelumab-ekko) - Severe Uncontrolled Asthma
Fit Score: 6/10 |
Ada Surface Ability: 7/10 |
Company Motivation: 8/10
Key Challenge
Large undertreated population (~900K-1.35M not on biologics) but low net revenue per patient ($22-25K/year). Alternative pricing model recommended: $500-1,000 flat fee per patient identified.
| Severe Uncontrolled Asthma (USA) |
~1-1.5 million |
| Undertreated (not on biologics) |
~900K-1.35M (90-95%) |
| Drug-Addressable Undertreated |
300-500K annually |
| Annual Revenue (FY2025) |
~$1.5B (+52% YoY) |
NOT RECOMMENDED (Scores <6)
| Drug |
Indication |
Fit Score |
Key Issues |
| Prolia |
Osteoporosis |
4/10 |
Low net revenue ($1,800-2K/year), asymptomatic, biosimilar competition (patents expired Feb 2025) |
| Enbrel |
RA, psoriasis, PsA, AS |
5/10 |
Revenue -33% in 2025, biosimilar competition, patent expires Nov 2028 |
| BLINCYTO |
B-cell ALL |
3/10 |
Acute emergency (11.5 days to diagnosis), inpatient pathway, small market |
| Otezla |
Psoriasis, PsA |
4/10 |
Low net revenue ($30K/year), patent expiration Feb 2028 |
| IMDELLTRA |
Small cell lung cancer |
3/10 |
Acute cancer presentation, inpatient pathway |
| LUMAKRAS |
KRAS G12C NSCLC/mCRC |
2/10 |
Requires genomic testing (Ada cannot identify mutation), oncology-managed |
| EVENITY |
Osteoporosis (high risk) |
4/10 |
Low net revenue ($13-14K/course), asymptomatic |
| Nplate |
Chronic ITP |
5/10 |
Small market (~20K new cases/year), borderline economics |
| KYPROLIS |
Multiple myeloma |
3/10 |
MM rarely underdiagnosed, relapsed/refractory indication, oncology pathway |
| Biosimilars |
Various |
N/A |
Low-margin commodity products, not aligned with Patient Finder model |
| MariTide |
Obesity (Pipeline) |
5/10 |
Not yet approved, low net revenue ($6-10K/year if approved), obesity not underdiagnosed |
Combined Opportunity Summary
Total Addressable Opportunity at 5% Penetration
| Tier |
Drugs |
Combined Opportunity |
| Tier 1 |
UPLIZNA + TEPEZZA |
$342M - $1.07B |
| Tier 2 |
KRYSTEXXA |
$598M - $1.98B |
| Tier 3 |
Repatha + TEZSPIRE* |
$544M - $2.15B |
| TOTAL (All Tiers) |
$1.48B - $5.20B |
*Tier 3 assumes alternative pricing models for Repatha and TEZSPIRE
Strategic Recommendations
Priority 1: Engage Amgen on Tier 1 Opportunities
UPLIZNA (Generalized Myasthenia Gravis)
- Why: Highest fit score (8/10); net revenue $200-220K/year; 1-2 year diagnostic delay; Ada can surface via ptosis + diplopia + fluctuating weakness
- Amgen motivation: Recent gMG approval (Dec 2025); 73% YoY growth; Horizon acquisition; pipeline expansions (AIH, CIDP)
- Revenue potential: $141-431M annually at 5% penetration
- Pitch angle: "Accelerate time-to-diagnosis for undiagnosed MG patients with classic symptom triad"
TEPEZZA (Thyroid Eye Disease)
- Why: Highest fit score (8/10); net revenue $300-350K/year (highest in portfolio); first-and-only FDA-approved treatment
- Amgen motivation: Monopoly positioning; $1.9B global sales (2024); subcutaneous formulation in Phase 3
- Revenue potential: $201-638M annually at 5% penetration
- Pitch angle: "Accelerate referrals from endocrinology to ophthalmology; maximize penetration of first-and-only treatment"
Priority 2: Explore KRYSTEXXA
- Why: Good fit score (7/10); net revenue $100-120K/course; first-mover monopoly
- Revenue potential: $598M-1.98B annually at 5% penetration (largest single opportunity)
- Challenge: Ada's detection capability is moderate (6/10) - requires patient to report existing gout diagnosis
Priority 3: Assess Alternative Models for Repatha & TEZSPIRE
- Repatha: Massive underdiagnosis (>98%) but low net revenue ($2.5-3K/year)
- TEZSPIRE: Large undertreated population but low net revenue ($22-25K/year)
- Alternative approach: Flat fee per patient identified ($500-1,000) rather than percentage-based model
- Combined potential: $13.7-37.8M annually at 1% penetration
Next Steps
- Prepare pilot proposals for UPLIZNA (gMG) and TEPEZZA (TED) with diagnostic delay data and Ada's detection capability demonstrations
- Engage Amgen Rare Disease leadership: Kave Niksefat (SVP Global Marketing & Access)
- Develop case studies demonstrating Ada's ability to surface MG and TED symptoms
- Negotiate pricing models:
- Tier 1 (UPLIZNA, TEPEZZA): 8-12% of first-year net drug revenue
- Tier 2 (KRYSTEXXA): 8-12% of first-year net drug revenue
- Tier 3 (Repatha, TEZSPIRE): Flat fee per patient ($500-1,000) or volume-based discounts