more than two months after biogen shares surged on the us food and drug administration’s controversial approval of its alzheimer’s disease therapy aduhelm investors’ focus has turned to the early uptake of the drug very early sales figures unveiled in late july fell slightly short of analysts’ expectations and the company has warned that the rollout will take time insight into the state of the uptake is turning muddier after two analysts published backtoback research notes painting different pictures of how early sales are progressing in a wednesday note piper sandler analyst christopher raymond cut his estimate for nearterm sales saying that an august survey of neurologists who treat alzheimer’s disease showed a downward shift in their projections of aduhelm’s use the survey conducted by the market research group spherix global insights polled 74 neurologists the results raymond wrote show that “the nearconstant stream of negative aduhelm headlines has impacted sentiment and nearterm expectations for uptake” raymond noted that the feedback from the neurologists included in the survey who practice at centers that biogen has said are ready to administer aduhelm was more positive still he wrote that the overall figures show neurologists expect aduhelm usage to grow more slowly than they had the last time the survey was taken raymond now expects 13 million in aduhelm sales in the third quarter of this year and 25 million in the fourth quarter down from his previous estimates of 40 million in the third quarter and 75 million in the fourth he expects 978 million in sales next year down from his previous estimate of 11 billion the factset analyst consensus estimate for 2022 is 13 billion raymond didn’t change his outlook for the years that follow saying that longterm projections remain favorable raymond’s view contrasts with a note published thursday by morgan stanley analyst matthew harrison citing another survey this one of 78 neurologists and conducted by morgan stanley harrison wrote that the survey suggested that aduhelm uptake was in line with his model “demand is expected to be strong given half of surveyed neurologists are willing to prescribe aduhelm either proactively or at the patientcaregiver’s request” harrison wrote harrison added that the survey shows some medicare administrative contractors are already reimbursing the drug reimbursement of the 56000peryear treatment has emerged as a significant potential issue in recent months with the centers for medicare and medicaid services which administered the medicare program launching a process in june to set a nationwide coverage policy “eight out of 78 neurologists have already prescribed commercial aduhelm” harrison wrote “of the 30 patients who received aduhelm 18 patients received the first dose and 6 patients were reimbursed by local medicare administrative contractor” in response to a request for comment on the notes biogen referred to statements made on the company’s earnings call in july at the time the company’s ceo said that patient interest in aduhelm was high but that it would take time for infusion sites to get “up and running” “our guidance continues to assume modest aduhelm revenue in 2021 due to dosing titration the need for sites to prepare to diagnose and treat patients and the time that it will take to secure payer coverage” the company’s cfo said on the call “we continue to expect revenue to start ramping in 2022 and beyond” shares of biogen were up 06 on thursday and are up 408 so far this year the stock climbed 383 on the day the fda issued its approval in june but is down 131 in the days since then the blowback against the aduhelm approval peaked in midjuly when the fda’s acting commissioner asked the acting inspector general of the department of health and human services to review the drug’s approval process