Myasthenia Gravis | Unmet Need | Generalized Myasthenia Gravis | US/EU | 2025

Myasthenia gravis (MG) is a rare neuromuscular disorder primarily caused by autoantibodies targeting acetylcholine (ACh) receptors and thus affecting neuromuscular synaptic transmission at the neuromuscular junction. It is a heterogenous disease; generalized MG (gMG) is characterized by the presence of autoantibodies for ACh receptors, while a subset of MG patients express other antibodies (e.g., anti-MuSK) or are seronegative. Its predominant manifestation is muscle weakness, particularly in the limbs or respiratory muscles, although some patients exclusively experience ocular symptoms. The FDA, EC, and MHRA have approved five therapies for MG: eculizumab (Alexion / AstraZeneca’s Soliris, biosimilars), efgartigimod alfa (Argenx’s Vyvgart / Vyvgart Hytrulo / SC), ravulizumab (Alexion / AstraZeneca’s Ultomiris), zilucoplan (UCB’s Zilbrysq), and rozanolixizumab (UCB’s Rystiggo). This report examines the influence of key clinical (e.g., change in QMG, MG-ADL, MGC) and nonclinical (i.e., patient out-of-pocket cost) attributes on neurologists’ prescribing decisions and assesses the key opportunities in the treatment of generalized MG that will be crucial to the strategic positioning of novel agents in this evolving market.

Questions answered

• What are the most important factors driving neurologists’ prescribing decisions for gMG? Do these factors differ between U.S. and European neurologists?
• When considering eculizumab, efgartigimod, ravulizumab, zilucoplan, and rozanolixizumab, which drug attributes are key influencers, which have limited impact, and which are the hidden opportunities in gMG?
• What are the prevailing areas of unmet need and opportunity in the gMG market?
• What trade-offs are surveyed neurologists willing to make across key clinical attributes and price for a new MG therapy?

Markets covered: United States, France, Germany, United Kingdom

Primary research: Survey of 60 U.S. and 30 European neurologists fielded in April 2025

Key drugs: Eculizumab, efgartigimod alfa, ravulizumab, zilucoplan, rozanolixizumab

Key feature: Target Product Profile (TPP) simulator tool allows for customizable market simulations based on conjoint analysis. Compare up to seven TPPs across multiple disease-specific attributes and price points to gauge which variables influence prescribing behavior.

Product description

Unmet Need offers insight into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities, enabling you to:

• Evaluate clinical and nonclinical product attributes that influence treatment decisions through physicians’ weightings and analysis of stated vs. derived importance.
• Pinpoint areas of high unmet need by assessing current drug performance against key attributes and treatment drivers.
• Analyze market scenarios for different target product profiles using the TPP Simulator.