Global Neurology Drugs Market Outlook, 2031

The global neurology drugs industry covers medicines for disorders of the brain, spinal cord, nerves and muscles, including multiple sclerosis, migraine, epilepsy, Parkinson's disease, Alzheimer's disease and other dementias, amyotrophic lateral sclerosis, spinal muscular atrophy, Duchenne muscular dystrophy, myasthenia gravis, neuropathic and acute pain, Huntington's disease, narcolepsy and other sleep disorders, and rare neurological diseases. The market includes very large volumes of generic drugs, such as levetiracetam, gabapentin, pregabalin, levodopa and sumatriptan, and high-value branded therapies. Major products include Roche's Ocrevus and Evrysdi, Novartis's Kesimpta and Zolgensma, Biogen's Spinraza, Tysabri and Leqembi with Eisai, Pfizer's Nurtec, AbbVie's Ubrelvy, Qulipta and Vyalev, Teva's Ajovy, Lilly's Emgality and Kisunla, Lundbeck's Vyepti, UCB's Briviact, Fintepla and Zilbrysq, SK Life Science's Xcopri, argenx's Vyvgart, Sarepta's Elevidys and Vertex's Journavx for acute pain. Other important companies include Sanofi, Merck KGaA, Johnson & Johnson, Takeda, Jazz, Neurocrine, Supernus, Acadia, Ionis, PTC Therapeutics and Intra-Cellular Therapies, acquired by Johnson & Johnson in 2025. Neurology is one of the most challenging areas of drug development because of the difficulty of reaching the brain, incomplete understanding of disease biology and high clinical trial failure rates, but it has become one of the most active areas of innovation. Neurology has seen major advances since 2020, alongside notable setbacks. Gene and antisense therapies transformed spinal muscular atrophy, and treatments such as Qalsody for SOD1-related ALS, approved in 2023, showed that genetic neurological diseases can be targeted. In migraine, CGRP-targeted drugs, including oral gepants, moved into mainstream prevention and acute treatment. Anti-amyloid antibodies became the first disease-modifying treatments for Alzheimer's disease in 2023 and 2024. In pain, the FDA approved Vertex's Journavx in January 2025, the first new class of non-opioid pain medicine in decades. In Parkinson's disease, AbbVie's Vyalev, a continuous subcutaneous levodopa infusion, was approved in October 2024. Multiple sclerosis moved toward more convenient high-efficacy therapies, including subcutaneous Ocrevus Zunovo in September 2024, although Sanofi's brain-penetrant BTK inhibitor tolebrutinib received an FDA complete response letter in December 2025. Several setbacks shaped the market: Amylyx withdrew Relyvrio for ALS in 2024 after a failed confirmatory trial, and Sarepta's Elevidys gene therapy for Duchenne muscular dystrophy faced safety restrictions in 2025 after patient deaths from liver failure. Myasthenia gravis became one of the fastest-growing neurology markets, with FcRn blockers and complement inhibitors approved, and rare disease therapies continued to command premium prices. Market Dynamics Market Drivers • High and Growing Burden of Neurological DisordersNeurological disorders are the leading cause of illness and disability worldwide, affecting more than three billion people according to a 2024 Lancet Neurology analysis. Stroke, migraine, dementia, epilepsy, Parkinson's disease and neuropathy are among the most common conditions, and ageing populations are increasing the prevalence of neurodegenerative diseases. Greater awareness, better diagnosis and new treatment options are bringing more patients into care. • Advances in Genetic, Antibody and Targeted TherapiesAdvances in understanding the genetics and biology of neurological diseases have enabled antisense oligonucleotides, gene therapies, monoclonal antibodies and precise small molecules. Spinal muscular atrophy, SOD1 ALS, hereditary transthyretin amyloidosis with polyneuropathy and Friedreich's ataxia now have targeted treatments, and many more are in development for Huntington's disease, Parkinson's disease and rare epilepsies. Biomarkers such as blood tests for neurofilament light and phosphorylated tau support diagnosis and trials. Market Challenges • High Clinical Failure Rates and Regulatory UncertaintyNeurology drugs fail in clinical trials more often than most other therapeutic areas because of the blood-brain barrier, heterogeneous diseases and difficult endpoints. Recent failures and regulatory setbacks, including tolebrutinib's complete response letter, Relyvrio's withdrawal and many failed Parkinson's and ALS programmes, increase risk for investors. Accelerated approvals based on biomarkers have been controversial, creating uncertainty for developers. • Pricing, Access and Safety ConcernsMany new neurology therapies carry very high prices, including gene therapies costing several million dollars and rare disease drugs priced at hundreds of thousands of dollars a year. Payers restrict access through prior authorisation and step therapy. Safety concerns, such as liver injury with gene therapies, brain swelling with anti-amyloid antibodies and progressive multifocal leukoencephalopathy with some MS drugs, require monitoring and can limit uptake. Market Trends • Convenient High-Efficacy TreatmentsNeurology treatments are becoming easier to take. Multiple sclerosis therapies are shifting to subcutaneous injections, including Kesimpta and Ocrevus Zunovo, and to oral high-efficacy drugs. Oral CGRP antagonists offer migraine prevention and treatment without injections, subcutaneous levodopa infusions provide continuous Parkinson's control, and Evrysdi became available as a tablet in 2025. Long-acting and at-home options reduce reliance on infusion centres. • Precision Neurology and Rare Disease FocusCompanies are increasingly targeting genetically defined and rare neurological diseases, where biology is clearer and regulatory pathways are more flexible. Antisense oligonucleotides, siRNA, gene therapies and gene-editing approaches are being developed for Huntington's disease, Angelman syndrome, Dravet syndrome, Rett syndrome, Friedreich's ataxia and genetic forms of ALS and Parkinson's disease. Individualised antisense therapies for single patients are also being explored. Segment Analysis Multiple sclerosis, migraine and epilepsy drugs account for a large share of neurology drug value, while neurodegenerative, neuromuscular and rare disease therapies are among the fastest-growing segments. Multiple sclerosis drugs, including anti-CD20 antibodies such as ocrelizumab, ofatumumab and ublituximab, natalizumab, S1P receptor modulators, cladribine and generic glatiramer and dimethyl fumarate, generate one of the largest shares of neurology revenue. Migraine drugs include CGRP monoclonal antibodies such as erenumab, fremanezumab, galcanezumab and eptinezumab, oral gepants such as rimegepant, ubrogepant, atogepant and zavegepant, triptans and botulinum toxin for chronic migraine. Epilepsy drugs include many generic anti-seizure medicines and branded products such as cenobamate, brivaracetam, fenfluramine, cannabidiol and ganaxolone. Parkinson's disease treatments include levodopa formulations, dopamine agonists, MAO-B inhibitors, COMT inhibitors and continuous infusion therapies such as foscarbidopa-foslevodopa. Alzheimer's disease drugs include symptomatic generics and anti-amyloid antibodies. Neuromuscular disease therapies include nusinersen, onasemnogene abeparvovec and risdiplam for spinal muscular atrophy, exon-skipping drugs, vamorolone and gene therapy for Duchenne muscular dystrophy, and FcRn blockers and complement inhibitors for myasthenia gravis. ALS treatments include riluzole, edaravone and tofersen. Pain medicines, including gabapentinoids, duloxetine, opioids and the non-opioid suzetrigine, treat neuropathic and acute pain. Sleep disorder, Huntington's disease and rare neurological disease treatments form further segments. Small molecules account for the largest volume of neurology drug use, while biologics, antisense therapies and gene therapies generate a rapidly growing share of value. Small molecules, taken mostly as oral tablets, include the vast majority of anti-seizure medicines, Parkinson's drugs, migraine triptans and gepants, oral MS therapies, sleep medicines, pain treatments and symptomatic Alzheimer's drugs, and many are available as generics. New branded small molecules, such as cenobamate, atogepant, suzetrigine and risdiplam, continue to be introduced. Monoclonal antibodies include anti-CD20 antibodies and natalizumab for MS, CGRP antibodies for migraine, anti-amyloid antibodies for Alzheimer's disease, FcRn blockers and complement inhibitors for myasthenia gravis and neuromyelitis optica spectrum disorder, and antibodies for other rare diseases. Antisense oligonucleotides, such as nusinersen for spinal muscular atrophy, tofersen for SOD1 ALS and eplontersen for hereditary transthyretin amyloidosis polyneuropathy, target the genetic causes of disease. Gene therapies, such as Zolgensma for spinal muscular atrophy and Elevidys for Duchenne muscular dystrophy, deliver functional genes but carry high prices and safety risks. Peptides and biologics, including zilucoplan and botulinum toxins, add further categories. Cell therapies, including stem cell-derived dopamine neurons for Parkinson's disease and CAR-T for autoimmune neurological diseases, are in clinical trials. Oral administration accounts for the largest share of neurology prescriptions, while injectable, infusion and intrathecal routes account for most high-value biologic and genetic therapies. Oral tablets, capsules and solutions are the standard route for most neurology drugs, including anti-seizure medicines, Parkinson's drugs, oral MS therapies, migraine treatments, pain medicines and symptomatic dementia drugs, and extended-release formulations improve symptom control. Orally disintegrating tablets, such as rimegepant, are used for acute migraine. Subcutaneous injections are used for ofatumumab and subcutaneous ocrelizumab in MS, CGRP antibodies for migraine prevention, FcRn blockers and complement inhibitors for myasthenia gravis, continuous levodopa infusion for Parkinson's disease and subcutaneous lecanemab for Alzheimer's disease. Intravenous infusions are used for ocrelizumab, natalizumab and ublituximab in MS, eptinezumab for migraine, anti-amyloid antibodies, gene therapies such as Zolgensma and Elevidys, and some myasthenia gravis treatments. Intrathecal injections into the spinal fluid are required for antisense drugs such as nusinersen and tofersen. Nasal sprays, including zavegepant and intranasal diazepam and midazolam for seizure clusters, offer rapid action. Transdermal patches, such as rotigotine for Parkinson's disease, and enteral gel infusions provide steady drug delivery. Inhaled formulations, such as levodopa inhalation powder, treat off episodes in Parkinson's disease. Hospital and specialty pharmacies dominate distribution of high-value neurology therapies, while retail pharmacies dispense most oral neurology prescriptions. Retail pharmacies dispense the majority of neurology prescriptions by volume, including anti-seizure medicines, Parkinson's drugs, oral migraine treatments, pain medicines and sleep medications. Specialty pharmacies in the United States handle high-cost oral and self-injected therapies, such as oral and subcutaneous MS drugs, CGRP antibodies, FcRn blockers and rare disease treatments, managing reimbursement and patient support. Hospital pharmacies and infusion centres administer intravenous biologics, anti-amyloid antibodies, intrathecal antisense drugs and gene therapies, and treat acute conditions such as stroke, status epilepticus and severe migraine. Specialist centres, including MS centres, comprehensive epilepsy centres, neuromuscular clinics and memory clinics, coordinate complex care and are often required for gene therapies. Online pharmacies and telehealth services have grown rapidly for migraine, insomnia and chronic pain, and direct-to-consumer telehealth platforms promote some migraine drugs. Government procurement and national formularies influence access in Europe and Asia, and China's volume-based procurement has reduced prices for generic neurology drugs. Patient assistance programmes and rare disease foundations help patients access costly therapies. Regional Analysis North America leads the neurology drugs market because of high prices, broad use of branded therapies for multiple sclerosis, migraine and rare diseases, and the concentration of neurology drug developers, while Asia-Pacific is the fastest-growing region with a large and ageing population. North America, led by the United States, accounts for the largest share of neurology drug revenue. The United States has high prices for MS, migraine, epilepsy and rare disease drugs, rapid adoption of new therapies and a large number of specialist centres, and the FDA approved many neurology drugs between 2023 and 2026, including Qalsody, Kisunla, Vyalev, Ocrevus Zunovo, Journavx and several myasthenia gravis treatments. Medicare price negotiation and generic entry for older neurology drugs are reducing revenue from some products, while regulatory setbacks such as tolebrutinib's complete response letter and safety issues with Elevidys have shaped the pipeline. Europe is the second largest market, with strong neurology research, broad access to MS and epilepsy treatments and cost controls from health technology assessment that restrict some high-cost therapies. Germany, France, the UK, Italy and Spain are the largest European markets. Asia-Pacific is the fastest-growing region, driven by ageing populations in Japan, China and South Korea, rising diagnosis of neurological diseases and expanding reimbursement for innovative drugs. Japan has a large neurology market and approved several therapies early, while China's neurology market is growing with domestic companies developing new treatments. India has a large epilepsy and stroke burden and relies mainly on generics. Latin America, the Middle East and Africa have growing neurology needs, with limited access to specialists and high-cost therapies in many countries. Key Developments December 2025: The FDA declined to approve Sanofi's brain-penetrant BTK inhibitor tolebrutinib for non-relapsing secondary progressive multiple sclerosis in its current form. July 2025: Following patient deaths from acute liver failure, the FDA requested a pause in Elevidys shipments for some patients and added safety warnings, reshaping the Duchenne gene therapy market. January 2025: Vertex's suzetrigine became the first new class of non-opioid pain medicine approved in more than two decades, targeting the NaV1.8 sodium channel. October 2024: AbbVie's foscarbidopa and foslevodopa became the first continuous subcutaneous levodopa-based infusion approved for motor fluctuations in advanced Parkinson's disease. September 2024: Roche's subcutaneous ocrelizumab was approved for relapsing and primary progressive MS, allowing a ten-minute injection twice a year instead of intravenous infusion. April 2024: Amylyx withdrew Relyvrio from the US and Canadian markets after its confirmatory phase 3 trial failed to show benefit in ALS. Considered in this report • Historic Year: 2020 • Base Year: 2025 • Estimated Year: 2026 • Forecast Year: 2031 Aspects covered in this report • Global Neurology Drugs Market with its value and forecast along with its segments • Various drivers and challenges • Ongoing trends and developments • Top profiled companies • Strategic recommendation By Disease • Multiple Sclerosis • Migraine • Epilepsy • Parkinson's Disease • Alzheimer's Disease and Dementia • Neuromuscular Diseases • Pain • Other Neurological Disorders By Drug Type • Small Molecules • Monoclonal Antibodies • Antisense Oligonucleotides • Gene Therapies • Other Biologics By Route of Administration • Oral • Subcutaneous • Intravenous • Intrathecal • Nasal and Transdermal By Distribution Channel • Retail Pharmacies • Specialty Pharmacies • Hospital Pharmacies • Online Pharmacies

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Sikandar Kesari

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