Sanofi/Regeneron forced to slash price in wake of slow sales

Sanofi and Regeneron were touted as having a sure-fire blockbuster on their hands when they first brought Praluent to market then they hit a snag – payers didn’t like the look of the price tag.

At a list price of $15,000, for a drug that stepped in when generic statin drugs failed at reducing LDL cholesterol, payers decided it wasn’t worth the money.

This meant that the PCSK9 inhibitors class, which includes Amgen’s Repatha, struggled to rack up the kind of sales that were expected; in fact, Praluent only managed $195 million in sales last year, despite being approved since 2015, and Repatha reaped just $319 million.

Sanofi and Regeneron have decided to attempt to boost sales by agreeing a deal that will see them reduce the price of the medicine to between $4,460 and $7,975, with the shortfall to the list price made up by rebates.

This price is what was deemed a fair price by the Institute for Clinical and Economic Review (ICER), after evaluation of the treatment.

The deal has, so far, been made exclusively with Express Scripts national formulary, which will see Praluent be part of the ‘Preferred’ medicine list – thereby achieving the additional bonus of ousting Amgen’s Repatha.

"This paradigm-shifting agreement is designed to break the gridlock so that Praluent is finally able to reach patients most in need," said Leonard Schleifer, President and Chief Executive Officer of Regeneron. "US cardiologists have experienced unprecedented challenges in securing access for Praluent for patients who were clearly appropriate, but were denied coverage. This agreement sets a new standard in industry and payer collaboration that we hope will serve as a model for how to make innovative medicines more accessible and affordable."

High cholesterol is a risk factor for heart disease and strokes but the numbers of people that may have required the medication to treat the condition would have added a huge and long-term burden to healthcare budgets at the previous price.

As a result, each prescription for the drug required a lengthy trail of paperwork to allow access to patients, which proved prohibitive for sales. This will now be replaced by a simplified attestation form, confirming that the therapy is appropriate for a particular patient.

Express Scripts, for its part, suggested that it will pass savings to eligible patients, potentially making this deal as "paradigm-shifting" as referenced by Schleifer; if other companies follow suit by allowing ICER to play a more active role in determining medicine value and companies follow through to increase patient access, it could herald the introduction of an alternative method of pricing.

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