Galderma Patient Finder Suitability Analysis

Ada Health — March 2026

Executive Summary

Analysis Scope: Comprehensive evaluation of Galderma Group AG's therapeutic drug portfolio for Ada Patient Finder suitability across prurigo nodularis, atopic dermatitis, rosacea, and acne indications.

1 TIER 1 Drug 1 TIER 2 Drug 6 Excluded 2 Pipeline

Primary Recommendation: Nemluvio (nemolizumab) for Prurigo Nodularis

Combined Ada Revenue Opportunity: $42.6M - $78.5M annually (PN + AD combined)

Portfolio Assessment: Executive Summary Table

Drug	Indication	Tier	Fit Score	Addressable Undiagnosed (USA)	Ada Revenue Opportunity
Nemluvio (nemolizumab)	Prurigo Nodularis	TIER 1	9/10	25,000 patients	$3.75M - $11.7M annually
Nemluvio (nemolizumab)	Atopic Dermatitis	TIER 2	7/10	487,000 patients	$14.6M - $36.5M annually
Epsolay	Rosacea	TIER 3	4/10	300,000 patients	$1.5M (NOT RECOMMENDED)
Epiduo / Epiduo Forte	Acne	NO	3/10	—	Generic competition, declining
Differin	Acne (OTC)	NO	1/10	—	OTC, no Rx required
Aklief	Acne	NO	3/10	—	No disclosed revenue
Dysport	Aesthetic / Therapeutic	NO	1-2/10	—	Elective/cosmetic use
Restylane	Aesthetic	NO	1/10	—	Elective/cosmetic use
Sculptra	Aesthetic	NO	1/10	—	Elective/cosmetic use

🎯 TIER 1 RECOMMENDATION: Nemluvio — Prurigo Nodularis

Fit Score: 9/10 | Strategic Priority: IMMEDIATE

Why This Is Exceptional:

Perfect Strategic Alignment: CEO's #1 priority product with >$4B peak sales target and $650M manufacturing investment
Significant Underdiagnosis: 50%+ undiagnosed due to low disease awareness and diagnostic delays
Highly Specific Symptoms: Chronic itch + nodular skin lesions = distinctive pattern Ada can identify (9/10 surfacing ability)
High Revenue Per Patient: $30,000 net revenue annually (WAC $55K with 40-50% rebates)
Manageable Pilot Scale: 25,000 U.S. addressable patients perfect for Ada proof-of-concept
Active Patient Finding: Galderma explicitly messaging "market expansion" with 35% new patient share within 18 months

Economic Opportunity:

5% Ada Penetration (Year 1 Target):	1,250 patients found
Annual Ada Revenue:	$3.75M (at 10% fee)
3-Year Lifetime Value:	$11.25M (chronic therapy assumption)
10% Penetration (Scaled):	$7.5M annual / $22.5M LTV

Pitch Hook:

"Prurigo nodularis affects 150,000 Americans, yet 50% remain undiagnosed due to low disease awareness and specialist access barriers—patients endure years of unbearable itch before reaching a dermatologist. Ada's symptom checker identifies the distinctive chronic itch + nodular lesion pattern in primary care touchpoints, surfacing undiagnosed patients for Nemluvio evaluation. With net revenue of $30K per patient annually and Galderma's >$4B peak sales target requiring aggressive patient identification, every 1,000 patients found represents $30M in lifetime value—justifying Ada's model at 8-12% of first-year revenue. We provide the scalable, non-DTC patient finding channel Galderma needs to expand this underdiagnosed market."

TIER 1: Nemluvio (nemolizumab) — Prurigo Nodularis

Section A — Market Numbers

United States Market

Prevalence & Underdiagnosis
Total Prevalent Cases	~150,000 patients (conservative midpoint) Range: 72-148 per 100,000 (0.072-0.15%) Sources: Plastic Surgery Practice, British Journal of Dermatology
Underdiagnosis Rate	50%+ (estimated) Evidence: Patients see multiple doctors over years before diagnosis; low disease awareness; fragmented care pathways Source: Galderma Diagnostic Delay Study
Undiagnosed Patients	75,000 patients

Drug-Addressable Funnel (USA)

Funnel Stage	Volume	% of Prior	Rationale
Total Undiagnosed PN	75,000	100%	50% underdiagnosis rate applied
Moderate-to-Severe (Nemluvio-eligible)	50,000	67%	~2/3 of PN cases are mod-severe
Adults (≥18 years)	50,000	100%	PN predominantly affects ages 50-60
Symptom-Expressers (health-seeking)	30,000	60%	Severe itch drives high engagement
Ada-Surfaceable	25,000	83%	Nodules + chronic itch = highly specific

Revenue Economics

Per-Patient Revenue (U.S.)
WAC (Wholesale Acquisition Cost)	$4,240 per 30mg pen × 13 doses/year = $55,120 annually Source: Galderma Colorado Prescriber Disclosure Jan 2025
Gross-to-Net Adjustment	40-50% (commercial payer rebates, co-pay support, Medicare)
Net Revenue Per Patient	$27,560 - $33,072 (midpoint: $30,000)
Patient Finder Fee (8-12%)	$2,400 - $3,600 per patient per year

Market Performance & Competition

FY 2025 Nemluvio Revenue (Total)	$452 million (split ~equally PN/AD) Source: Galderma Annual Results 2025
PN-Specific Estimated Revenue	~$226 million (U.S.-driven)
Peak Sales Target (Both Indications)	>$4 billion (raised from >$2B) Source: Fierce Pharma, March 2026
Patent/Exclusivity	~12 years U.S. biologics exclusivity from Aug 2024 approval = ~2036

Top Competitors

Competitor	Mechanism	Market Position
Dupixent (dupilumab) Sanofi/Regeneron	IL-4/IL-13 inhibitor	First FDA-approved PN biologic (2022) ~65% new patient share (vs Nemluvio 35%) Source: FDA approval announcement, Galderma investor slides
Topical Corticosteroids Various generics	Anti-inflammatory	First-line therapy 38.9% ointment share of overall PN market Source: GM Insights PN Treatment Market
No third biologic competitor (Rinvoq used off-label in some cases but not FDA-approved for PN)

Section B — Clinical & Diagnostic Profile

            Distinctive Symptom Pattern (High Ada Surfacing Potential)
            Primary: Intense, persistent itching (often described as "unbearable") refractory to topical treatments
Dermatological: Nodular skin lesions (firm, dome-shaped bumps) on arms, legs, trunk
Secondary: Sleep disturbance, excoriation marks, lichenification
Duration: Chronic (>6 weeks); 77.6% of cases last >1 year

        

Diagnostic Barriers

Documented Delay	Patients see multiple doctors over years before diagnosis Source: Galderma Diagnostic Journey Study
Key Barriers	• Low disease awareness among primary care providers • Chronic scratching misunderstood as behavioral/psychiatric issue • Specialist referral bottlenecks • Fragmented care with trial-and-error treatments
Common Misdiagnoses	Eczema/atopic dermatitis, psoriasis, contact dermatitis, psychiatric disorder
Who Diagnoses	Dermatologists (specialist-level diagnosis); primary care sees patients first but often lacks familiarity

✅ Ada Symptom Assessment Capability: 9/10

Why High Confidence:

Chronic itch (>6 weeks) + nodular lesions = highly specific pattern
Sleep disturbance + refractory to OTC treatments increases differentiation
Location pattern (extremities, trunk) helps rule out facial dermatoses
Low overlap with common conditions (nodular lesions are rare)
Can identify patients in pre-specialist phase (primary care touchpoint)

Section C — Commercial & Strategic Signals

🔥 STRONG STRATEGIC SIGNALS FOR PATIENT FINDING

Launch Timing: U.S. FDA approval August 2024; rapid 35% new patient share by January 2026
"Market Expansion" Positioning: Galderma explicitly emphasizes expanding diagnosed/treated population (not just switching from Dupixent)
Salesforce Expansion: Increased commercial team for patient identification and prescriber engagement
"Market-Leading Education": Comprehensive provider/patient programs targeting undiagnosed population
Manufacturing Investment: >$650M through 2030 for Nemluvio production
Peak Sales Guidance Doubled: From >$2B to >$4B (requires finding many more patients)
CEO Priority: Nemluvio described as "transformative asset" and cornerstone of growth strategy

Section D — Patient Finder Opportunity Assessment

Economic Opportunity by Market

Market	Drug-Addressable Undiagnosed	Net Revenue/Patient/Year	PF Fee (8-12%)	Total Annual Opportunity
USA	25,000	$30,000	$2,400-$3,600	$60-90 million
DACH	20,000	$42,500	$3,400-$5,100	$68-102 million
Rest of World	33,000	$35,000	$2,800-$4,200	$92-139 million
TOTAL	78,000	—	—	$220-331 million

Realistic U.S. Scenarios

Scenario	Penetration	Patients Found	Annual Ada Revenue	3-Year LTV
Conservative (1% penetration)	1%	250	$750K	$2.25M
Year 1 Target (5% penetration)	5%	1,250	$3.75M	$11.25M
Scaled (10% penetration)	10%	2,500	$7.5M	$22.5M

Fit Assessment Scores

Dimension	Score	Rationale
Ada Surface Ability	9/10	Highly specific symptom pattern; low overlap; can identify in pre-specialist phase
Company Motivation	10/10	CEO #1 priority; $650M investment; >$4B peak target requires patient finding; "market expansion" explicit
Overall Fit Score	9/10	ALL CRITERIA MET: Diagnostic delay ✓ \| Revenue >$10K ✓ \| Underdiagnosis >20% ✓ \| Perfect strategic alignment

TIER 2: Nemluvio (nemolizumab) — Atopic Dermatitis

⚠️ Large Opportunity, Competitive Market

Fit Score: 7/10 — Strong fundamentals but competitive dynamics reduce conversion probability vs Tier 1 PN indication.

Section A — Market Numbers (USA)

Prevalence & Underdiagnosis
Total U.S. Prevalence	~26 million (16.5M adults + 9.6M children) Adults: 7.3-7.6% \| Children: 10.8% Sources: AAFA, Allergy & Asthma Network
Moderate-to-Severe AD	~9.6 million (6.6M adults + 3M children) ~40% of diagnosed adults are mod-severe
Underdiagnosis Rate (7MM)	60% undiagnosed (only 40% diagnosed) Source: Clinical Trials Arena / GlobalData 7MM analysis
Undiagnosed Mod-Severe (USA)	5.8 million patients

Drug-Addressable Funnel (Nemluvio-Specific)

Funnel Stage	Volume	% of Prior	Rationale
Total Undiagnosed Mod-Severe	5,800,000	100%	60% underdiagnosis applied
Eligible for Biologics (failed topicals)	2,900,000	50%	Not all mod-severe need biologics
Itch-Dominant Patients	1,450,000	50%	Nemluvio's IL-31 differentiation vs Dupixent/Rinvoq
Adults + Adolescents ≥12	1,160,000	80%	Nemluvio approved for ≥12 years
Symptom-Expressers	696,000	60%	Severe itch drives engagement
Ada-Surfaceable	487,000	70%	Moderate specificity (eczema overlap)

Revenue & Competition

FY 2025 Nemluvio AD Revenue	~$226 million (increasing rapidly; split moving toward AD-heavy) Source: Galderma Annual Results
Nemluvio AD Market Share (Jan 2026)	8% of new U.S. AD patient starts vs 35% in PN — room for growth
Dupixent AD Revenue (2025)	~$11.2-11.4 billion globally 58-60% AD market share Sources: Vision Research Reports, Pharma Tech
Total AD Market (7MM, 2025)	$19.1-19.4 billion Dupixent dominates; JAK inhibitors (Rinvoq) fastest-growing

Section D — Opportunity Assessment

Realistic Ada Scenarios (Focused on Itch-Dominant Subset)

Scenario	Ada Penetration	Patients Surfaced	Nemluvio Conversion	Nemluvio Patients	Annual Ada Revenue
Realistic (5% / 20%)	5%	24,350	20%	4,870	$14.6M
Scaled (10% / 25%)	10%	48,700	25%	12,175	$36.5M

Note: Lower conversion vs PN (20-25% vs ~80%+) due to Dupixent/Rinvoq competition. Many surfaced patients choose established competitors.

Fit Scores

Ada Surface Ability	7/10	Itch + eczematous pattern surfaceable but moderate specificity; focus on itch + sleep disturbance improves precision
Company Motivation	9/10	AD drives majority of >$4B peak target; heavy investment; but competitive market = less urgency than PN
Overall Fit Score	7/10	TIER 2: Large opportunity but competitive; best if Ada targets itch-dominant subset specifically

TIER 3 / LOW PRIORITY: Epsolay (Rosacea)

Fit Score: 4/10 — Low revenue per patient ($800-1,250/year topical) kills economics despite moderate underdiagnosis.

Quick Assessment:

Revenue Per Patient: $800-1,250/year (below $10K threshold)
Drug-Addressable (USA): ~300,000 patients
Ada Revenue (5% penetration): $1.5M — too low to justify effort
Not CEO Priority: No mention in earnings or strategic priorities
No Disclosed Revenue: Galderma does not report Epsolay separately

Recommendation: NOT RECOMMENDED — Better for content marketing than active Patient Finder program.

EXCLUDED DRUGS (NO PATIENT FINDER FIT)

Drug	Indication	Exclusion Rationale
Epiduo / Epiduo Forte	Acne	Generic competition (LOE 2021), declining revenue, low revenue/patient ($500-800/year), minimal underdiagnosis value
Differin	Acne (OTC)	OTC since 2016, mass market ($15-30), no Rx required, no diagnosis needed
Aklief	Acne	No disclosed revenue, mature market, minimal underdiagnosis, low revenue/patient
Dysport	Aesthetic & Therapeutic	Aesthetic: elective/cosmetic, no diagnosis \| Therapeutic: no underdiagnosis (clinically obvious neurological conditions)
Restylane	Aesthetic (HA Fillers)	Elective/cosmetic, no medical diagnosis, marketing-driven acquisition
Sculptra	Aesthetic (Biostimulator)	Elective/cosmetic, no medical diagnosis required

PIPELINE DRUGS (MONITOR FOR FUTURE)

Drug	Indication	Status	Potential Fit	Recommendation
Nemolizumab	Systemic Sclerosis	Phase 2 (completion 2028)	TBD (proof-of-concept stage)	Monitor for Phase 3 advancement; revisit 2027-2028
Nemolizumab	Chronic Pruritus of Unknown Origin (CPUO)	Phase 2 (completion 2026)	HIGH (Tier 1 potential if approved)	HIGH POTENTIAL: Large undiagnosed population (1.2-3.9M USA), no approved competitors. Engage Galderma 2027 for pre-launch discussions if Phase 2 positive.

Strategic Recommendations

Immediate Action Plan (2026)

1. PRIORITY: Initiate Nemluvio PN Partnership

Timeline: Q2 2026 outreach to Galderma commercial leadership
Pilot Structure: U.S.-focused, 12-month initial commitment
Target: Surface 1,250 patients (5% of 25K addressable) in Year 1
Revenue Goal: $3.75M annual Ada fees; $11.25M 3-year LTV
Expansion: DACH market in Year 2 if U.S. pilot successful

2. EVALUATE: Nemluvio AD Opportunity

Approach: Focus on itch-dominant subset to differentiate from Dupixent/Rinvoq
Symptom Checker Emphasis: Chronic itch + sleep disturbance + refractory to topicals
Pilot Strategy: Run alongside PN program; measure Nemluvio conversion vs competitors
Decision Point: Q4 2026 — assess viability based on conversion rates

3. MONITOR: Nemolizumab CPUO Pipeline

Phase 2 Data: Expected 2026
Action Trigger: Positive efficacy/safety → engage Galderma Q1 2027
Potential: Tier 1 fit if approved (large undiagnosed population, no competitors)

Proposed Partnership Structure

Term	Proposed Structure
Fee Structure	10% of first-year net revenue per patient found and converted
Payment Trigger	Patient fills first Nemluvio prescription (verified via specialty pharmacy data)
Attribution Window	90 days from Ada symptom check to Rx fill
Commitment	3-year partnership with annual performance review
Exclusivity	Ada exclusive patient-finding partner for Nemluvio PN in U.S. (optional DACH expansion Year 2)
Data Sharing	Ada provides quarterly analytics: symptom patterns, conversion rates, patient journey insights

Value Proposition to Galderma

            Why Galderma Should Partner with Ada
            Non-DTC Market Expansion: Aligns perfectly with Galderma's "market expansion" positioning (not DTC advertising)
Scalable Patient Identification: Ada symptom checker reaches health-seeking patients before specialist visit, complementing salesforce efforts
Data-Driven Insights: Ada provides analytics on symptom patterns, diagnostic journeys, and conversion funnels
Complements Existing Programs: Salesforce focuses on prescriber engagement; Ada surfaces the patients
Risk-Sharing Model: Performance-based fees (only pay when patient converts)
Fast Time-to-Value: Pilot can launch within 3 months; first patients surfaced within 6 months

        