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Wednesday, October 24, 2018

Amgen cuts price of cholesterol drug by almost 60%, echoing rival's move

Biotech giant Amgen is lowering the price of its cholesterol medicine Repatha by almost 60 percent, following a similar move from its competitor, after both drugs failed to meet sales expectations.

The new price of the medicine will be $5,850 per year, Amgen said in a statement Wednesday. That's down from an annual price of $14,100, before discounts and rebates. The company said its goal is for the reduction to lower patients' copays, particularly those covered by Medicare.

"We've heard from too many patients, particularly Medicare beneficiaries, that they can't afford their out-of-pocket copays, so we're lowering the list price of Repatha today," Amgen Chief Executive Officer Bob Bradway said in a telephone interview with CNBC. The new price, he said, should lower those patients' copays from about $370 a month to a range of $25 to $150.

The company attributed the move both to its participation in an American Heart Association initiative focused on value, and its support of the Trump administration's goal to lower drug prices. Amgen said that in May it decided not to take price increases planned for July, and doesn't plan any for the rest of 2018.

Earlier this year, Regeneron and its partner Sanofi said they were lowering the price of their competing cholesterol drug, Praluent, from $14,600 a year to a range between $4,500 and $8,000.

A key difference is that Amgen is changing the sticker price of its drug -- known in industry parlance as the wholesale acquisition cost, or WAC. Regeneron and Sanofi made the change in the form of paying a larger rebate to pharmacy benefit manager Express Scripts; the WAC remained the same. In exchange, Express Scripts booted Amgen's drug from coverage on its largest formulary plan.

Bradway said the company has been offering significant rebates to payers this year in exchange for greater insurance coverage, but noted those agreements don't always result in lower out-of-pocket costs for patients.

Express Scripts said Wednesday that Regeneron and Sanofi's Praluent remains the preferred medication on its National Preferred Formulary plan, while Repatha is still excluded. The company may re-evaluate Repatha's status based on Amgen's price reduction, Jennifer Luddy, Express Scripts' director of corporate communications, told CNBC by email.

"With a new lower list price for Repatha, Amgen is taking an important step forward to help payers be better positioned to provide breakthrough medicines and help people achieve better outcomes," Express Scripts Chief Medical Officer Dr. Steve Miller said in Amgen's statement.

Neither Amgen's nor Regeneron and Sanofi's drug has been a major moneymaker since they were approved in 2015, despite billion-dollar expectations, as many patients faced trouble with insurance reimbursement. Regeneron and Sanofi's Praluent drew $195 million in 2017 revenue, while Amgen's Repatha brought in $319 million.

They're in a class known as PCSK9 inhibitors that have been shown to dramatically lower levels of so-called bad, or LDL, cholesterol. Subsequent large-scale clinical trials proved they also reduce the risk of heart attack and stroke.

Regeneron and Sanofi's trial also showed a mortality benefit, meaning fewer patients taking the drug died during the study than those on a placebo, something Express Scripts cited in announcing it would exclude Amgen's drug from coverage on its largest plan.

In an example of the complexity of drug pricing, Amgen said it's bringing the lower-priced Repatha to market by introducing new National Drug Codes — the product will be identical, but it will be offered at two prices for a period of time. The company said it expects to discontinue the original list price by the end of 2020 as it works with insurers and pharmacy benefit managers to transition to the new price.

"While we hope more patients will benefit from swift adoption of these lower-priced options, it is ultimately a payer decision," Murdo Gordon, Amgen's executive vice president of global commercial operations, said in the statement.

Gilead recently made a similar move to lower the price of its hepatitis C drugs. In another example of drug pricing's complexity, it did so by introducing authorized generic versions — identical medicines, without the brand names, at a lower list price than the original.

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