Second Price Cut for PCSK9 Inhibitor Alirocumab (Praluent)

Patrice Wendling

February 12, 2019

The cholesterol-lowering drug alirocumab (Praluent) will be available at a new list price of $5850 a year for the 75 mg and 150 mg doses beginning in early March, according to Sanofi and partner Regeneron Pharmaceuticals.

This follows the drug makers' March 2018 decision to lower the net cost of alirocumab in exchange for greater patient access from payers, with Express Scripts agreeing to make alirocumab the exclusive proprotein convertase subtilisin-kexin type 9 (PCSK9) on its national preferred formulary.

"We were encouraged to see improvements in accessibility following our collaboration with payers last year to provide more straightforward, affordable access to Praluent, but only some patients had reduced out-of-pocket costs," Michelle Carnahan, North America Head of Primary Care Business Unit at Sanofi, said in a statement

"With today's announcement, we are looking to help bridge that gap, and have now made Praluent available at a price that is approximately 60% lower," she said. "We hope that payers will do their part to help ensure savings are directly passed on to more patients, through lower out-of-pocket costs."

The companies estimate with the new pricing that most Medicare Part D patients will pay between $25 and $150 per month, a potential savings of up to $345, depending on their insurance plan. Eligible commercial patients will continue to have access to copay assistance via MyPraluent.

The newly priced drug is expected to be available for pharmacies to order in early March, and doses with the original list price will remain on the market at least through 2019, according to the release.

In October 2018, Amgen cut the price of its PCSK9 inhibitor, evolocumab (Repatha), by roughly 60% to $5850 a year. Both drugs struggled to gain a foothold in the market at their original price of about $14,000 per year and were stymied by onerous approval processes and frequent rejections.

Calls for greater access to PCSK9 inhibitors have heated up for high-risk patients with elevated cholesterol despite maximally tolerated statins after two key outcomes trials. Last year, the ODYSSEY Outcomes trial reported a 15% reduction in cardiovascular (CV) events and all-cause death at 2.8 years with alirocumab, and in 2017, the FOURIER trial reported a 15% reduction in CV-event risk with evolocumab, using a softer major adverse cardiovascular events (MACE) definition with no mortality benefit at 2.2 years.

Follow Patrice Wendling on Twitter: @pwendl. For more from theheart.org | Medscape Cardiology, follow us on Twitter and Facebook.

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