Section 5 of 6

Economic information and modeling report

13 evidence topics · 8 sources

Modeling overview

Summary

No economic model, cost-effectiveness analysis, budget impact analysis, or health technology assessment of LB-102 was identified, and LB Pharmaceuticals has announced no price. No published peak sales estimate or market research forecast naming LB-102 was retrieved. The company sizes the United States branded antipsychotic market at approximately $12 billion, reports that four branded products accounted for approximately 60% of 2025 sales (Vraylar $3.6 billion, Rexulti $1.9 billion, Abilify $1.1 billion, Caplyta $0.9 billion), and states that antipsychotic development typically starts in schizophrenia “to anchor dose and premium pricing” before expansion into bipolar depression and major depressive disorder. Two analyst firms that initiated coverage in October 2025 each used the term “blockbuster” for the LB-102 opportunity, and neither notice gives a sales figure. The Form 10-K lists price, the level of generic competition, and the availability of reimbursement among the competitive factors for LB-102.

The closest recent comparator launch is xanomeline-trospium (Cobenfy, studied as KarXT), approved in September 2024 at a list price of $1,850 per month, or $22,500 per year. Before approval, the Institute for Clinical and Economic Review modeled KarXT against aripiprazole with a placeholder price of $20,000 per year and reported $163,000 per quality-adjusted life-year gained and $146,000 per equal-value life-year gained, with a health-benefit price benchmark of $16,000 to $20,000 per year. Its budget impact analysis estimated 3,459,146 eligible adults in the United States and found that approximately 8% of them could be treated at the placeholder price within a threshold of $735 million per year. The appraisal committee voted 10 to 2 that the evidence was inadequate to show a net health benefit superior to aripiprazole, and the policy recommendations described limited prior authorization as reasonable given uncertainty about long-term effectiveness. A 2025 conference analysis that used a lifetime Markov model estimated $727,796 per quality-adjusted life-year gained for xanomeline-trospium compared with aripiprazole.

Published economic model, cost-effectiveness analysis, budget impact analysis, or health technology assessment of LB-102

No evidence found.

Announced price, pricing guidance, or payer contracting strategy for LB-102

No evidence found.

Company market sizing: United States branded antipsychotic market

“The U.S. market for branded antipsychotic drugs was approximately $12 billion as of 2024.” (opens the source at this quote in a new tab)
“Despite the widespread use of generic antipsychotic drugs, several of these branded drugs each generate U.S. sales in excess of $1 billion annually.” (opens the source at this quote in a new tab)
“Among the schizophrenia drugs with greater than $1 billion in sales, all have approvals in additional indications beyond schizophrenia, such as mood disorders.” (opens the source at this quote in a new tab)

“2025 Branded AP Sales in U.S.: ~$12B” (opens the source at this quote in a new tab)
“Four Branded APs Account for ~60% of Sales” (opens the source at this quote in a new tab)

Branded antipsychotic	Share of 2025 United States branded antipsychotic sales and amount
Vraylar	“30% ($3.6B)”
Rexulti	“15% ($1.9B)”
Abilify	“9% ($1.1B)”
Caplyta	“8% ($0.9B)”
All other antipsychotics	“38% ($4.6B)”

Company statements on pricing and commercial positioning

“Development of APs typically starts in SCZ to anchor dose and premium pricing; enables efficient expansion to bipolar depression and MDD, increasing the addressable market by ~10x” (opens the source at this quote in a new tab)
“LB-102 has Potential to be the Branded AP of Choice in SCZ” (opens the source at this quote in a new tab)

“It is well recognized that in the United States, antipsychotic drugs have higher prices than antidepressants, such as the selective serotonin reuptake inhibitors.” (opens the source at this quote in a new tab)
“We believe that LB-102, if approved, can become a mainstay of psychiatric practice by offering a potentially attractive alternative to branded and generic therapeutics for the treatment of schizophrenia, bipolar depression, adjunctive MDD and other neuropsychiatric diseases, given the compelling balance of clinical activity and tolerability observed to date.” (opens the source at this quote in a new tab)

Company statements on amisulpride use and treatment switching as indicators of demand

“Additionally, data from 2023 show that despite limited marketing efforts, there were at least two million monthly prescriptions per year for amisulpride in the European Union.” (opens the source at this quote in a new tab)
“The high incidence of schizophrenia, inadequate clinical response, and side effects from current therapeutics lead to a discontinuation rate of 74% within 18 months of treatment and present a clear market opportunity for more effective schizophrenia drugs that are well-tolerated.” (opens the source at this quote in a new tab)

Company statements on payer coverage and price competition

“There is significant uncertainty related to third-party payor coverage and reimbursement of newly approved products.” (opens the source at this quote in a new tab)
“Some third-party payors may require pre-approval of coverage for new or innovative drug therapies before they will reimburse healthcare providers who use such therapies.” (opens the source at this quote in a new tab)
“We believe the key competitive factors affecting the success of our product candidate, LB-102, that we are developing to address schizophrenia, bipolar depression, and adjunctive MDD, if approved, are likely to be efficacy, safety, frequency” (opens the source at this quote in a new tab)
“of dosing, convenience, price, the level of generic competition, and the availability of reimbursement from government and other third-party payors.” (opens the source at this quote in a new tab)

Royalty obligations on net sales of LB-102

“In August 2023, contemporaneously with the closing of the Series C financing, we entered into several Amended and Restated Royalty Agreements to remove the expiration date and modify royalties payable to certificate holders in the aggregate amount of up to 2.75% of net sales of LB-102 through December 31, 2035 and increasing to up to 3.25% of net sales in 2036 and thereafter.” (opens the source at this quote in a new tab)

Analyst statements at initiation of coverage, October 2025

“The drug is Phase 3-ready with a blockbuster schizophrenia U.S. opportunity, the analyst tells investors in a research note.” (opens the source at this quote in a new tab)

“The firm says its bullish thesis is based on enthusiasm for LB-102, which it thinks can become a blockbuster antipsychotic for the treatment of schizophrenia and mood disorders.” (opens the source at this quote in a new tab)

Published peak sales estimate or market research forecast naming LB-102

No evidence found.

Comparator launch: xanomeline-trospium (Cobenfy) list price

“Cobenfy will cost $1,850 for a month's supply or $22,500 annually before insurance and other rebates, according to Bristol Myers Squibb executives.” (opens the source at this quote in a new tab)
“They said that pricing is in line with existing branded oral schizophrenia treatments” (opens the source at this quote in a new tab)

Comparator economic evaluation: ICER model of KarXT (xanomeline-trospium), structure and price assumption

“was used to evaluate the lifetime cost-effectiveness of KarXT compared with the current standard of care, including second-generation antipsychotic medications.” (opens the source at this quote in a new tab)
“The model included both a decision tree for acute psychosis and a lifetime Markov model reflecting maintenance treatment.” (opens the source at this quote in a new tab)
“Individuals started on either KarXT or aripiprazole, and, if treatment was discontinued, they moved to a second treatment market basket, including risperidone and olanzapine.” (opens the source at this quote in a new tab)
“The base case was from the health care sector perspective, and all future costs and outcomes were discounted at 3% per year.” (opens the source at this quote in a new tab)
“The price of KarXT was unknown at the time of this evaluation. Therefore, we used a placeholder price of $20,000 per year in the economic model.” (opens the source at this quote in a new tab)

Comparator economic evaluation: ICER base-case results and health-benefit price benchmark

Outcome	KarXT at a placeholder price of $20,000 per year
Cost per QALY gained	“$163,000”
Cost per evLY gained	“$146,000”
Cost per life-year gained	“$347,000”
Cost per year without diabetes	“$60,000”

“Using this same assumption, we calculated ICER’s Health Benefit Price Benchmark (ie, the price range that would achieve incremental cost-effectiveness ratios between $100,000 and $150,000 per quality-adjusted life-year or per equal-value life-year gained) to be between $16,000 and $20,000 per year.” (opens the source at this quote in a new tab)
“However, a key assumption that we varied based on short-term data was that KarXT was not associated with increased metabolic risk beyond that of the general population. This assumption is a key driver of the cost-effectiveness findings.” (opens the source at this quote in a new tab)

Annual prices using	Annual price at $100,000 threshold	Annual price at $150,000 threshold
QALYs gained	“$16,000”	“$19,000”
evLYs gained	“$16,000”	“$20,000”

Comparator economic evaluation: ICER potential budget impact of KarXT

Eligible population input	Quoted value
Prevalence of schizophrenia for US adults	“1.8%”
Average projected US adult population size over five years, 2023 to 2027	“269,529,814”
Adults with schizophrenia estimated to be receiving antipsychotic medication	“71.3%”
Annual five-year budget impact threshold for new drugs	“approximately $735 million per year”

“Applying these sources results in estimates of 3,459,146 eligible adults with schizophrenia in the US.” (opens the source at this quote in a new tab)
“For the purposes of this analysis, we will assume that 20% of these individuals would initiate treatment in each of the five years, or 691,829 adults with schizophrenia per year.” (opens the source at this quote in a new tab)
“At KarXT’s placeholder price of $20,000 annually, the average annual budget impact per patient treated, per year, was $2,060 in Year one with cumulative net annual costs increasing to $21,570 in Year five.” (opens the source at this quote in a new tab)
“At the placeholder price, approximately 8% of adults living with schizophrenia who are eligible for treatment could be treated with KarXT without crossing the ICER potential budget impact threshold of $735 million per year.” (opens the source at this quote in a new tab)
“At prices to reach thresholds of $150,000, $100,000, and $50,000 per QALY ($19,102, $15,569, and $12,035), approximately 8%, 12%, and 24% of adults living with schizophrenia who are eligible for treatment, respectively, could be treated over five years without reaching the ICER potential budget impact threshold of $735 million per year.” (opens the source at this quote in a new tab)
“ICER is not issuing an access and affordability alert for KarXT. The actual price of KarXT is unknown.” (opens the source at this quote in a new tab)

Comparator economic evaluation: ICER appraisal committee votes and coverage recommendation

“A majority of the panel (10-2) voted that the evidence is not adequate to demonstrate that the net health benefit of KarXT is superior to that of aripiprazole.” (opens the source at this quote in a new tab)
“However, a slight majority of the panel (7-5) voted that the current evidence is adequate to demonstrate a superior net health benefit of KarXT from that provided by olanzapine and/or risperidone.” (opens the source at this quote in a new tab)
“There was no vote on long-term value for money because the price for KarXT was not available at the time of this review.” (opens the source at this quote in a new tab)
“Specifically, given the significant uncertainty about the long-term effectiveness of KarXT and its presumed high cost in relation to available generic treatment options, it is reasonable for payers to use limited prior authorization as a component of coverage if KarXT receives FDA approval.” (opens the source at this quote in a new tab)

Comparator economic evaluation: cost-effectiveness of xanomeline-trospium compared with aripiprazole, conference abstract

“We developed a lifetime Markov model from a U.S. healthcare perspective in Excel that simulated a cohort of adults with schizophrenia during the maintenance period and recorded treatment-emergent adverse events, treatment switching, treatment discontinuation, and death over three-month cycles.” (opens the source at this quote in a new tab)
“Compared to aripiprazole, xanomeline and trospium chloride increased lifetime QALYs by 0.10, costs by $71,228, and yielded an ICER of $727,796/QALY gained.” (opens the source at this quote in a new tab)
“We found that xanomeline and trospium chloride would be cost-effective at $150,000/QALY if the total healthcare costs for a three-month cycle did not exceed $5,950.” (opens the source at this quote in a new tab)

Budget impact model

Approach and framework

No evidence found.

Perspective and time frame

No evidence found.

Epidemiology and eligible population inputs

No evidence found.

Cost assumptions

No evidence found.

Model outcomes

No evidence found.

Results

Base case

No evidence found.

Scenario analyses

No evidence found.

Budget impact model discussion

No evidence found.