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 U.S. regulators last Friday approved the first of the new medicines,
Praluent, from Regeneron Pharmaceuticals Inc and Sanofi SA. Given
every other week by injection, Regeneron said it will have a
wholesale price of $1,120 for a 28-day supply. That comes to almost
$15,000 a year.
Standard older cholesterol fighters such as statins, including
generic forms of Pfizer Inc's Lipitor and Merck & Co's Zocor, can
cost less than $50 a month.
A rival treatment from Amgen Inc, called Repatha, is expected to
gain U.S. approval next month. The new drugs work by blocking the
protein PCSK9, whose natural function is to prevent "bad" LDL
cholesterol from being removed from the bloodstream.
Express Scripts, which administers drug benefits for employers and
health plans and also runs large mail-order pharmacies, has been
challenging the rising cost of new medications.
"While these drugs are being viewed as breakthroughs, they also have
the potential to wreak financial havoc on clients who do not
proactively manage" their drug costs, Express Scripts President Tim
Wentworth said during a conference call to discuss the company's
quarterly earnings.
Glen Stettin, a senior Express Scripts executive, said an estimated
70 million Americans have high cholesterol.
He estimates fewer than 10 percent of them should qualify for
Praluent, based on restrictions from the Food and Drug
Administration, which limited the drug's use mostly to patients with
a hereditary form of high cholesterol and people with cardiovascular
disease.
"The big worry for our clients, given the cost of these drugs, is
whether they will be used beyond ways they were tested," Stettin
said.
Before getting their prescriptions filled, patients in Express
Scripts plans will be asked for documentation of their diagnosis,
their cholesterol levels, diet and maximum tolerated statin therapy,
Stettin said.
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Express Scripts has become a vocal critic of highly priced
medicines, including Sovaldi, an $84,000 hepatitis C treatment from
Gilead Sciences Inc. A rival treatment from AbbVie Inc was approved
late last year, and Express Scripts successfully pressured both
companies to lower prices.
Similarly, Stettin said the expected approval of Amgen's cholesterol
fighter, Repatha, should help Express Scripts push for lower prices
on both drugs.
"We love competition because we know we can leverage that," Stettin
said. He declined to estimate how big the discounts might be.
Officials at Regeneron were not available to comment. Amgen, in an
emailed statement, said it believes its Repatha will offer value for
those who need to further reduce their LDL. "We look forward to
working with payers to ensure that these patients can access Repatha,
and that it fits within the needs of the overall healthcare system,"
the company said.
(Reporting by Ransdell Pierson; Editing by Marguerita Choy, Dan
Grebler and Bernard Orr)
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