Amgen Cuts Repatha's Price 60% as Scrutiny of Drug Costs Heats Up

Patrice Wendling

October 24, 2018

Amgen announced today it is lowering the cost of its cholesterol-lowering drug, evolocumab (Repatha), by roughly 60%.

The new list price for the proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitor is $5850 a year, down from its original list price of more than $14,000 a year.

The move was designed to increase demand by lowering out-of-pocket costs, especially for Medicare patients, who currently pay between $280 and $370 a month in out-of-pocket costs, but will now pay $25 to $150 a month, Amgen officials said in a telephone press briefing.

Three out of four Medicare patients abandon their PCSK9 inhibitor prescription mainly because of high out-of-pocket costs, according to Amgen Chair and Chief Executive Officer Robert Bradway.

Cardiologists have also long complained about the steep cost and byzantine approval process for the drug, which was approved in the US in 2015, with added indications coming in 2017.

Sales continued to lag behind projections following the 2017 FOURIER outcomes trial. In that trial, evolocumab was associated with a dramatic 59% reduction in LDL cholesterol when added to statins, but did not significantly reduce cardiovascular or all-cause death compared with placebo at 22 months in patients with atherosclerotic cardiovascular disease.

The new pricing decision comes as the White House is calling for greater transparency and lower drug prices and has scheduled an appearance Thursday by President Donald Trump at the US Department of Health and Human Services (HHS).

Asked during the call to what extent the decision was influenced by the administration's proposals, Amgen's Executive Vice President of Global Commercial Operations Murdo Gordon said, "You can imagine that thinking through this decision, a significant amount of time predates even the most recent actions and discussions from HHS or the administration.

"We clearly understood after the results of the FOURIER trial that we needed to find a way to make Repatha available for as many of the 3.4 million high-risk cardiovascular patients in the market, and the only way to do that was to address the high out-of-pocket costs," he said.

Amgen was already using a rebate program to address payer reimbursement but that was not helping patients on the Medicare part D side, he said.

The newly priced drug will be available tomorrow under a new drug code, but, because Medicare part D plans are designed in the spring for the following calendar year, the new pricing comes too late for 2019 Medicare D plans, Gordon said.

"However, health plans and [pharmacy benefit managers] have the ability to make off-cycle additions to their formularies, so we will be talking to those plans in the next days and weeks to encourage them to list Repatha at the new low list price, sooner rather than later," he said.

Notably, this spring Regeneron Pharmaceuticals and partner Sanofi cut the net price of its PCSK9 inhibitor, alirocumab (Praluent), in exchange for more patient access from Express Scripts, which agreed to make alirocumab the exclusive PCSK9 inhibitor on its national preferred formulary.

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