Galderma significantly raised its annual peak sales forecast for Nemulvio (nemolizumab) to more than $4 billion, double the previous estimate of more than $2 billion. The update follows what CEO Fleming Ornskov described as an “outstanding launch trajectory” for the inflammatory skin disease treatment in its first full year on the market.
Nemulvio recorded sales of $452 million in 2025, driven by strong adoption in existing indications of atopic dermatitis and prurigo nodularis (PN). Growth accelerated sharply in the second half of the year, with the period contributing $321 million to the total. This is due to real-world experience with the IL-23 receptor inhibitor that exceeded initial expectations, Ornskov said during Galderma’s fourth-quarter earnings call on Thursday.
Galderma said sales of Nemulbio are currently split about 50-50 between the two indications, but the contribution of atopic dermatitis, a market about 10 times larger than PN, is rapidly increasing.
When it comes to eczema, Ornskov said, citing research, doctors are preferring Nemulbio over unknown “major brands” for anti-itch remedies. That treatment is likely to be Dupixent, with sales reaching 4.2 billion euros ($4.9 billion) in the fourth quarter across multiple immunological indications, Sanofi reported last month.
Ornskov said doctors are focusing most on alleviating itching, and Nemulvio is recognized as a differentiated, first-line treatment.
When Nemulvio won FDA approval for eczema in December 2024, Jefferies analysts noted that the drug’s ability to quickly relieve itch “may be particularly attractive to many patients.” Combined with convenient eight-weekly maintenance dosing, Nemulvio “offers an attractive option for patients not being managed with Dupixent,” analysts said in a note at the time. At the time, the Jefferies team estimated Nemrubio’s potential for maximum global sales at $2.1 billion, including $1.5 billion from atopic dermatitis.
In Galderma’s survey, among physicians with limited experience using Nemulvio, awareness of the drug lagged significantly behind leading brands in both achieving clear or near-clear skin and “providing safe and well-tolerated treatment,” the company reported. But these scores highlighted a better-than-expected experience that tipped Nemruvio in favor of its competitors among doctors who had been using it well, resulting in improved peak sales, Ornskov said.
Jefferies analysts recently conducted an independent survey of 30 U.S. physicians and reported that in five years, Nemrubio is expected to be used in 13% of first-line atopic dermatitis patients and 15% of second-line patients. These numbers were significantly higher than the 6% to 11% range the team had previously reported. As a result, the Jefferies team raised its peak sales forecast for Nemruvio in February to $4.2 billion.
In the U.S., from the end of 2025 to January 2026, Nemruvio’s share of new patient initiations remained at about 35% for PN and 8% for eczema, with the majority of patients in both categories receiving new biologics, Ornskov said. Approximately 85% of patients in commercial plans are insured for Nemulbio as a first-line biologic treatment, and Galderma just secured first-line access for the first of four major Medicare payer agreements.
Before formal Medicare policy was introduced, when doctors applied for coverage under the medical exception process, Nemruvio had a very high success rate. This “means doctors really want this product for their patients,” Ornskov said.
Although international sales represent only a fraction of the drug’s current sales, Nemruvio’s launch momentum outside the U.S. is “getting even stronger.” In Germany, its first market outside the U.S., Nemrubio has an even larger market share in total prescriptions than in the U.S., and in the U.K., sales are “significantly ahead” of sales expectations, Ornskov said.
Some of the pricing discussions are “a bit difficult” for some international markets, such as Spain, Ornskov said.
“But all of these countries have cumulatively performed so well that I think we’ll see a continuation of very strong performance as we learn from some of our best launches to date,” the CEO added.
Outgoing Chief Financial Officer Thomas Dietrich said Nemrubio continued to weigh on Galderma’s revenue in 2025, with a $153 million impact on the company’s profits as it invested in start-up and operations. But Ornskov said Galderma expects the financials around Nemurbio to break even in 2026, a year earlier than originally expected.
Mr. Dietrich is leaving Galderma to pursue a new senior management opportunity outside the company. Last month, Galderma announced that Luigi La Corte, who previously served as chief financial officer (CFO) of Italian pharmaceutical company Recordati, will take up the position on May 1.
Thanks to Nemluvio, Galderma’s dermatology therapeutics category sales increased 50% year over year at constant currency to $1.2 billion. The $5.2 billion performance represents a 17.7% growth rate compared to 2024 sales, with companywide net sales exceeding $5 billion annually for the first time.
